Effect of Varicocelectomy on Testicular Volume in Children and Adolescents: A Meta-analysis

被引:42
作者
Li, Fuping
Chiba, Koji
Yamaguchi, Kohei [1 ]
Okada, Keisuke
Matsushita, Kei
Ando, Makoto
Yue, Huanxun
Fujisawa, Masato
机构
[1] Kobe Univ, Grad Sch Med, Dept Surg Related, Div Urol,Fac Med,Chuo Ku, Kobe, Hyogo 6500017, Japan
关键词
CATCH-UP GROWTH; SEMEN PARAMETERS; REPAIR; HYPOTROPHY; ARTERY; BOYS;
D O I
10.1016/j.urology.2012.02.022
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE To evaluate the effect of surgical intervention on catch-up growth as determined by a decreased testicular volume discrepancy in children and adolescents with varicocele. METHODS A systematic search was performed using MEDLINE and the PubMed database and cross-referenced as of October 28, 2011 using the terms "varicocele," "children," "adolescent," "surgery," and "testicular volume." All relevant studies were of the testicular volume discrepancy variance before and after surgical repair. The outcomes included the number of patients with initial testicular atrophy and those with catch-up growth after surgical repair. The database search, quality evaluation, and data extraction were independently performed by 2 reviewers. RESULTS Of 75 studies, 14 were included for analysis and involved 1475 patients. The combined analysis showed that the testicular volume discrepancy was significantly reduced after surgery in the >= 10% group (P < .00001) and >= 20% group (P < .00001), respectively. No difference was found between the 2 groups (P = .70). Taken together, the number of patient with testicular volume disproportion in all pediatric and adolescent varicocele patients significantly decreased after surgery (P < .00001). The average proportion of catch-up growth was 76.4% (range 52.6%-93.8%). CONCLUSION The meta-analysis suggested clear advantages of surgical intervention on reducing testicular hypotrophy when the discrepancy is >= 10% in children and adolescents with varicocele. Additional prospective and controlled studies are warranted to elucidate the treatment of children and adolescents with varicocele. UROLOGY 79: 1340-1345, 2012. (C) 2012 Elsevier Inc.
引用
收藏
页码:1340 / 1345
页数:6
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