Management of childhood and adolescent varicocele : experience at prince rashid bin al-hassan hospital-jordan

Abstract EN

Objective: The aim of this retrospective study is to evaluate if the early repair of varicocele in children and adolescents can prevent testicular growth arrest and male infertility later on.

Methods: During a three year period (2004- 2006), 70 children and adolescents with varicocele who were operated on at Prince Rashid Hospital were reviewed (mean age 15 years, 9-19 years).

All patients had been evaluated by a urologist or a pediatric surgeon.

High ligation of the internal spermatic vein was carried out either by open retroperitoneal approach or transperitoneal laparoscopic approach.

Results: Of the 70 patients 39 had grade II varicocele and 31 had grade III varicocele.

In 33 patients (49%), the disease was associated with ipsilateral testicular growth arrest.

In seven patients (10%), the disease was associated with impaired seminal fluid analysis parameters, four patients had recurrence of varicocele, and three patients developed hydrocele.

Of 33 patients with testicular growth arrest, 32 ( 97% ) regained normal testicular volume post operatively, while six of the seven patients with impaired seminal fluid analysis achieved normal parameters after surgery.

Conclusion: Varicocele can affect ipsilateral testicular growth and seminal fluid analysis parameters, which may adversely affect fertility.

We recommend early recognition and treatment.