Ipsilateral Testicular Catch-Up Growth Rate Following Microsurgical Inguinal Adolescent Varicocelectomy

Orhun Sinanoglu,Sinan Ekici,Seyit Erkan Eyyupoglu

doi:10.1100/2012/356374

Abstract

Objective. To evaluate the ipsilateral catch-up growth rates compared to contralateral testicular growth in adolescents with varicocele undergoing microsurgical inguinal varicocelectomy. Materials and Methods. Between December 2005 and May 2007, 39 adolescent patients with grade 2-3 varicocele admitted to our clinic with complaints of pain and/or testicular asymmetry were operated. Preoperative mean age was 14.5 ± 1.96 (9–17). Testicular volumes were assessed with ultrasound every 3 months. The available followup was 39 months. Results. In our series, mean testicular preoperative volumes were 9.07 ± 3.19 mL for the right and 5.90 ± 1.74 mL for the left. Mean testicular volumes at the end of follow up were 13.97 ± 3.42 mL for the right and 12.20 ± 4.05 mL for the left. The testicular catch-up growth approximately begins after the 9th month and significant catch-up occurred in the 12–24 months (P < 0.05). Conclusion. Since testicular volume is the primary method of assessing testicular function in adolescents, testicular size can predict future fertility status significantly 9 months after surgical varicocele correction.

Highlights

The varicocele is the most common surgically reversible cause of male infertility
It is accepted that the treatment of varicocele during childhood should be concomitant with the onset of ipsilateral testicular growth arrest [6, 7]
The evidence suggest that varicocelectomy is beneficial to adolescents with ipsilateral testicular hypotrophy since untreated varicocele was shown to have progressive deleterious effects on the future fertility status [15]

Summary

Introduction

The varicocele is the most common surgically reversible cause of male infertility. The prevalence of varicocele is approximately 15–20% in general population and 30–40% among infertile men [1]. Changes in semen quality are considered as the first indication for surgery in adults, it is usually accepted that the treatment of varicocele in adolescence is indicated with the onset of testicular growth retardation and testicular pain, considering that these patients may manifest impaired fertility in adult age [7]. In order to evaluate testicular improvement after surgery, the term “catch up growth” was introduced first by Kass and Belman into the literature [12]. This compensatory increase in testicular size which was found to be correlated with functional improvement [8, 10]. Both clinical and ultrasonographic examinations are performed to confirm ipsilateral catch-up growth and to rule out recurrence as well [12]

Methods

Results

Conclusion