Adolescent varicocele

Abstract

The incidence of varicocele in older adolescence varies from 12.4% to 17.8% with an average of 14.7%, similar to the incidence in adult males. Varicocele is associated with testicular growth arrest in adolescents. Varicocelectomy can reverse the testicular growth arrest. But without the testicular growth arrest, prophylactic surgery for every adolescent with varicocele is not advised. Surgery treatment should be offered to: 1. adolescents with testicular growth arrest more than 2 ml of difference between left and right testicle, 2. adolescents with abnormal semen analysis with high-grade varicocele, 3. adolescents with symptoms: pain, heaviness, swelling, 4. adolescents with bilateral varicoceles. Recurrence of the varicocele after surgery treatment can occur in 9% to 16% of adolescents. But rate of recurrence can be kept below 2% in adolescents treated by high retroperitoneal ligation with testicular artery ligation.