Clinical assessment after varicocelectomy.

The present study, conducted in Hong Kong, was designed to evaluate the clinical assessment and interobserver variation between doctors with different levels of training in the assessment of recurrent varicoceles, and to compare their findings with those made by ultrasound. Fifteen patients, previously operated for left varicocele testis, were evaluated clinically by four observers. The mean age was 12.9 years (range 8-15 years) at surgery. The testicular texture, size and flow with and without the Valsalva manoeuvre were determined by colour Doppler sonography. The follow-up time was 6-48 months after surgery. The echotexture of the testes was normal in all patients. The mean volumes of the left and right testes were equal after surgery (left 9.0 ml [range 2.4-15.2 ml and right 8.7 ml [range 3.4-15.6 ml]). There was large variation between observers in the predictability of both positive and negative clinical findings of varicocele testis when compared with ultrasound. Objective assessment in grading varicocele testis and testicular volume using ultrasound is required for both clinical management and scientific research.