Management of childhood and adolescent varicocele: experience at Prince Rashid Bin Al-Hassan Hospital-Jordan

ABSTRACT

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. 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. 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. Varicocele can affect ipsilateral testicular growth and seminal fluid analysis parameters, which may adversely affect fertility. We recommend early recognition and treatment