PURPOSE: Through a school screening program for varicocele we studied the prognostic value of hemodynamic vs clinical grading for predicting the risk of progression, time to worsening and the final outcome in adolescents with varicocele. MATERIALS AND METHODS: A school screening program was set up for boys between ages 10 and 16 years to assess pubertal development, varicocele, testicular vein reflux and testicular volume. Those who eventually had ipsilateral testicular hypotrophy underwent surgery. All patients underwent semen analysis after age 18 years. Varicocele grade was correlated with pubertal development, testicular vein reflux and semen quality in all groups, whether treated or untreated. RESULTS: A total of 2,107 boys were screened, of whom 609 had a varicocele. By the end of the study 92 patients (15.1%) had undergone surgery. Hypotrophy correlated with spontaneous testicular vein reflux (high grade) in all cases. Semen analysis showed abnormal results in 36% treated and 20% untreated patients. CONCLUSIONS: Children with varicocele should be regularly monitored to identify varicocele grade, testicular volume and vein reflux grade, and management should be determined accordingly. Spontaneous venous reflux toward the testis independent of varicocele grade closely correlates with the onset of testicular hypotrophy and abnormal semen analysis.
PURPOSE: Through a school screening program for varicocele we studied the prognostic value of hemodynamic vs clinical grading for predicting the risk of progression, time to worsening and the final outcome in adolescents with varicocele. MATERIALS AND METHODS: A school screening program was set up for boys between ages 10 and 16 years to assess pubertal development, varicocele, testicular vein reflux and testicular volume. Those who eventually had ipsilateral testicular hypotrophy underwent surgery. All patients underwent semen analysis after age 18 years. Varicocele grade was correlated with pubertal development, testicular vein reflux and semen quality in all groups, whether treated or untreated. RESULTS: A total of 2,107 boys were screened, of whom 609 had a varicocele. By the end of the study 92 patients (15.1%) had undergone surgery. Hypotrophy correlated with spontaneous testicular vein reflux (high grade) in all cases. Semen analysis showed abnormal results in 36% treated and 20% untreated patients. CONCLUSIONS:Children with varicocele should be regularly monitored to identify varicocele grade, testicular volume and vein reflux grade, and management should be determined accordingly. Spontaneous venous reflux toward the testis independent of varicocele grade closely correlates with the onset of testicular hypotrophy and abnormal semen analysis.
Authors: Fevzi Bedir; Ercüment Keskin; Mehmet Karabakan; İbrahim Karabulut; Fatih Kürşat Yılmazel; Ertuğrul Gazi Özbey; Yılmaz Aksoy; İsa Özbey Journal: Turk J Urol Date: 2017-05-03
Authors: Simon Freeman; Michele Bertolotto; Jonathan Richenberg; Jane Belfield; Vikram Dogra; Dean Y Huang; Francesco Lotti; Karolina Markiet; Olivera Nikolic; Subramaniyan Ramanathan; Parvati Ramchandani; Laurence Rocher; Mustafa Secil; Paul S Sidhu; Katarzyna Skrobisz; Michal Studniarek; Athina Tsili; Ahmet Tuncay Turgut; Pietro Pavlica; Lorenzo E Derchi Journal: Eur Radiol Date: 2019-07-22 Impact factor: 5.315
Authors: Jason P Van Batavia; Elizabeth Lawton; Jennifer R Frazier; Stephen A Zderic; Mark R Zaontz; Aseem R Shukla; Arun K Srinivasan; Dana A Weiss; Christopher J Long; Douglas A Canning; Thomas F Kolon Journal: J Urol Date: 2020-10-07 Impact factor: 7.450