1261 TOTAL BUT NOT DIFFERENTIAL TESTICULAR VOLUMES CORRELATE WITH SPERM COUNTS IN ADOLESCENT VARICOCELE PATIENTS

Abstract

You have accessJournal of UrologyPediatrics: Imaging Genital & Urinary Tract/Infections and Vesicoureteral Reflux/Andrology - Cryptorchidism & Varicoceles1 Apr 20101261 TOTAL BUT NOT DIFFERENTIAL TESTICULAR VOLUMES CORRELATE WITH SPERM COUNTS IN ADOLESCENT VARICOCELE PATIENTS Thomas Kolon, Angela Kalmus, Aileen Schast, Pasquale Casale, Michael Carr, Howard Snyder, Douglas Canning, and Stephen Zderic Thomas KolonThomas Kolon More articles by this author , Angela KalmusAngela Kalmus More articles by this author , Aileen SchastAileen Schast More articles by this author , Pasquale CasalePasquale Casale More articles by this author , Michael CarrMichael Carr More articles by this author , Howard SnyderHoward Snyder More articles by this author , Douglas CanningDouglas Canning More articles by this author , and Stephen ZdericStephen Zderic More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.806AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Management of the adolescent with a varicocele remains controversial. While some have argued for surgical correction if the affected testicular volume is 20% less than that of its contralateral mate, we have noted that 80% of these volume discrepancies correct over time without surgery. In this study, we correlate differential and total testicular volumes with semen analyses obtained once the patients had reached 18 years of age. METHODS Records of patients followed nonsurgically for a diagnosis of varicocele were reviewed after patients returned with a completed semen analysis. Testicular volumes were determined by ultrasound using the Lambert formula at 1 year intervals. Differential testicular volume was calculated as affected testis/total testicular volume x 100. The best and worst volume differential for each patient was used for this analysis (t-test). RESULTS 48 patients were followed for an average of 3.2 ± 1.6 years and underwent an average of 4.2 ± 2.5 ultrasound studies, For all 48 patients the mean total sperm count was 43 million ± 44 (range 0-240). The worst testicular differential volume recorded for each patient was 43.6 cc ± 4.1 (range 43-66); the best was 51.7 cc ± 5 (range 34-50). The best and worst testicular differential volumes were then analyzed for total sperm counts above and below 40, 30, 20, and 10 million. For each of these categories, the testicular differential volumes did not differ (p=NS). However the mean sum of the total testicular volumes (right and left) taken at the last ultrasound differed substantially for those patients with a total sperm count less than 40 million (35.1 ± 10.9) versus those with a count above 40 million (43.5 ± 10) (p= 0.02). CONCLUSIONS From these data we conclude that: i)differential testicular volume is not predictive of future total sperm count. ii) the diminished bilateral testicular volume observed in those patients with the worst semen parameters supports a possible underlying endocrinopathy. Philadelphia, PA© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e488 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Thomas Kolon More articles by this author Angela Kalmus More articles by this author Aileen Schast More articles by this author Pasquale Casale More articles by this author Michael Carr More articles by this author Howard Snyder More articles by this author Douglas Canning More articles by this author Stephen Zderic More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...