Repair versus observation in adolescent varicocele: A prospective study

Purpose: We designed a randomized prospective study of male adolescents with moderate and severe varicoceles to determine whether prophylactic varicocele repair is beneficial. Materials and Methods: We evaluated 2,100 boys (10 to 20 years old) for genitourinary abnormalities. From this population 2 groups of adolescents 15 to 19 years old with grade 2 or 3 varicoceles were created, including 88 who underwent varicocele repair and 36 controls. Testicular volume and pampiniform vein diameter were measured, and Doppler ultrasound was performed. Results: After 12 months volume of the involved left testis increased to almost normal in treated boys (mean atrophy index 12.7% at surgery and 3% 12 months later), In controls the corresponding atrophy indexes were 10 and 9%, respectively. The relative increase in left testicular volume was 26% in the surgery group and 11% in controls. In the surgery group mean pampiniform vein diameter decreased from 2.8 preoperatively to 2 mm. postoperatively but there was no change in controls. Conclusions: Varicocele repair in adolescents with moderate and severe varicocele reversed testicular growth arrest and resulted in catch-up growth within 12 month of surgery.