MP26-08 1. CHILDHOOD VARICOCELES DO NOT LEAD TO PROGRESSIVE TESTICULAR ATROPHY/HYPOTROPY

Abstract

You have accessJournal of UrologyPediatrics: Testis, Varicocele & Stones1 Apr 2014MP26-08 1. CHILDHOOD VARICOCELES DO NOT LEAD TO PROGRESSIVE TESTICULAR ATROPHY/HYPOTROPY Siddharth Khasnavis and Barry Kogan Siddharth KhasnavisSiddharth Khasnavis More articles by this author and Barry KoganBarry Kogan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.896AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Varicoceles in children and adolescents present a challenging problem. Although varicoceles have the potential to affect fertility, only about 20% of adults with a varicocele are affected. Testicular atrophy/hypotrophy has been used as a proxy for future fertility issues. We studied the incidence and progression of testicular size discrepancy in a series of children followed non-operatively. METHODS We identified 104 consecutive children seen by us for left sided varicocele. Surgery was only undertaken in 3 who were being operated on for other reasons. We retrospectively reviewed those with at least 3 consecutive annual follow-ups. There were 35 boys, ages 9-14 years. Varicocele grade and orchidometric volumes were recorded for the initial and subsequent yearly visits. Paired t-tests were used to compare the mean size of the left testicle as a percentage of the right. Likewise, unpaired t-tests were used to compare testicular volumes between patients aged 9-11 and 12-14 at a single time point. We also tracked patients with >10% difference in testicular size and those with grade 3 varicoceles at initial visit. RESULTS In our study population the median age was 12 (range 9-14). The mean grade of varicocele was 2.3 +/- 0.6. The median interval between 1st and 3rd visit was 2.0 years (range 1.3-3.1). We found the mean left testicular volume to be 96, 95 and 96 % of the right at the 1st, 2nd and 3rd visit respectively. When the population was split into pre- (9-11 yrs, n= 9) and post-pubertal (12-14, n= 26) groups there were again no differences. 13 (37%) of the boys presented with a grade 3 varicocele. In this group, left testicular volume was 95% (SD 11.4) of the right at presentation and was unchanged through visit 3 (96%, p=0.69). 11 patients (31%) had a > 10% size difference at presentation. In this group, the left testicle measured 82% of the right (SD 5.3) at diagnosis and increased to 92% (SD 6.3) by the 3rd visit (p<0.001). Finally, in 23 children, we reviewed data from a 4th visit (median of 3.3 yrs) and in 12, a 5th visit (median of 4.4 yrs). In these boys, mean left testicular volume was 99% of the right at diagnosis and 104% and 104% at the 4th and 5th visit (p=0.13). CONCLUSIONS We found no progression in atrophy/hypotrophy of the left testis in a series of consecutive patients followed non-operatively for varicocele. Indeed there was slight improvement in relative volume in 31% of patients who presented with >10% asymmetry. Our data supports observation as management for childhood varicocele as most cases fail to show progressive loss of volume. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e253-e254 Peer Review Report Advertisement Copyright & Permissions© 2014MetricsAuthor Information Siddharth Khasnavis More articles by this author Barry Kogan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...