Koji Shiraishi1, Hideyasu Matsuyama. 1. Department of Urology, Yamaguchi University School of Medicine, Yamaguchi, Japan. shirak@yamaguchi-u.ac.jp
Abstract
OBJECTIVE: To predict testicular catch-up growth after varicocelectomy, we investigated the usefulness of testicular temperature (TT) measurements for adolescent varicocele. MATERIALS AND METHODS: The present study included 110 patients with left varicocele patients (age 9-17 years, mean ± standard deviation 12.5 ± 2.4) who had undergone varicocelectomy (87 patients) or observation (23 patients). In addition to the physical examination and duplex/color Doppler ultrasonography, the pre- and postoperative TT was measured using a CoreTemp CTM204 device (Terumo, Tokyo, Japan). Testicular catch-up growth was evaluated 2 years after the operation or initial visit. Univariate and multivariate statistical analyses were performed to determine whether patient age, varicocele grade, testicular asymmetry, TT, and endocrinologic results could be used as determinants of catch-up growth. RESULTS: Left testicular hypotrophy was noted in 34 patients (31%), and TT elevation was observed in 58 patients (53%). In the observation group, 9 patients (39%) showed new-onset testicular hypotrophy. Patients with TT elevation in this group had a significantly greater incidence of new-onset hypotrophy compared with those without TT elevation (P <.05). Patients with catch-up growth after varicocelectomy had a greater grade of varicocele, more preoperative testicular hypotrophy, and TT elevation (P <.05, P <.05, and P <.0001, respectively). Multivariate statistical analyses revealed that TT elevation was significantly associated with catch-up growth after varicocelectomy (P <.05). CONCLUSION: The measurement of scrotal temperature is a helpful approach to identify patients at a greater risk of progressive testicular hypotrophy and catch-up growth after varicocelectomy.
OBJECTIVE: To predict testicular catch-up growth after varicocelectomy, we investigated the usefulness of testicular temperature (TT) measurements for adolescent varicocele. MATERIALS AND METHODS: The present study included 110 patients with left varicocele patients (age 9-17 years, mean ± standard deviation 12.5 ± 2.4) who had undergone varicocelectomy (87 patients) or observation (23 patients). In addition to the physical examination and duplex/color Doppler ultrasonography, the pre- and postoperative TT was measured using a CoreTemp CTM204 device (Terumo, Tokyo, Japan). Testicular catch-up growth was evaluated 2 years after the operation or initial visit. Univariate and multivariate statistical analyses were performed to determine whether patient age, varicocele grade, testicular asymmetry, TT, and endocrinologic results could be used as determinants of catch-up growth. RESULTS:Left testicular hypotrophy was noted in 34 patients (31%), and TT elevation was observed in 58 patients (53%). In the observation group, 9 patients (39%) showed new-onset testicular hypotrophy. Patients with TT elevation in this group had a significantly greater incidence of new-onset hypotrophy compared with those without TT elevation (P <.05). Patients with catch-up growth after varicocelectomy had a greater grade of varicocele, more preoperative testicular hypotrophy, and TT elevation (P <.05, P <.05, and P <.0001, respectively). Multivariate statistical analyses revealed that TT elevation was significantly associated with catch-up growth after varicocelectomy (P <.05). CONCLUSION: The measurement of scrotal temperature is a helpful approach to identify patients at a greater risk of progressive testicular hypotrophy and catch-up growth after varicocelectomy.