title: Idiopathic varicocele in adolescents: risks of the inguinal approach.
abstract: BACKGROUND
  The aim of this study was to evaluate the medium-term results and complications of open inguinal varicocelectomy, including vein ligation, intraoperative venography, and antegrade sclerotherapy.
  
  
  METHODS
  Sixty-four children were treated between 2000 and 2009 for idiopathic varicocele. Fifty children were examined 6 months after surgery. In 2010, 22 patients were recalled for testicular ultrasound scans (US) to evaluate the medium-term results of the technique.
  
  
  RESULTS
  The mean age of the children was 12.8 years at first consultation. Of the 50 cases, 35 children were asymptomatic, 13 experienced pain, 3 suffered from discomfort, and 1 had testicular asymmetry. Thirteen children had delayed left testicular growth compared with the right testis. The mean age at surgery was 13.3 years, and follow-up duration was 8.3 months ± 13.9. Thirty-eight patients achieved good results postsurgery; there was varicocele recurrence in 3, testicular hypotrophy in 7, and complete testicular atrophy in 2 patients.
  
  
  CONCLUSIONS
  Naked eye inguinal surgical ligation does not appear to be safe enough to treat young adolescents, with the theoretical risk of a decrease in fertility in the future. In teams which are untrained in microsurgical or laparoscopic varicocelectomy, we suggest referring adolescent patients to a radiologist for embolization.
authors.affiliation: Department of Pediatric Surgery, CHU Charles Nicolle, Rouen, France. mariette.renaux-petel@hotmail.fr
authors.forename: Mariette
authors.initials: M
authors.lastname: Renaux-Petel
authors.forename: Pierre-Hugues
authors.initials: PH
authors.lastname: Vivier
authors.forename: Diane
authors.initials: D
authors.lastname: Comte
authors.forename: Marion
authors.initials: M
authors.lastname: Beurdeley
authors.forename: Agnès
authors.initials: A
authors.lastname: Liard
authors.forename: Bruno
authors.initials: B
authors.lastname: Bachy
mesh_terms: D000293:Adolescent; D005500:Follow-Up Studies; D006119:Groin / Q000601:surgery; D006801:Humans; D007264:Inguinal Canal; D008026:Ligation; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D013737:Testis / Q000473:pathology*; D016896:Treatment Outcome; D014463:Ultrasonography; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy