Boys with Varicocele May Outgrow Size Disparity

Many adolescents with varicocele have testicular 'catch-up' growth without requiring surgery

TUESDAY, July 22 (HealthDay News) -- Many adolescent boys with a varicocele will have "catch-up" growth that reduces their testicular size discrepancy without requiring surgical repair, according to research published in the July issue of Urology.

Mark A. Preston, of the Children's Hospital of Eastern Ontario in Ottawa, Ontario, Canada, and colleagues assessed 33 boys with a median age of 13.4 years, almost all of whom presented with grades 3 and 2 varicocele. The subjects were followed for a median 2.1 years. One patient required surgical intervention during the study for pain, and two others needed surgery for worsening testicular hypotrophy.

Among the boys with a larger right testicle at diagnosis, the researchers noted a significant decrease in the percentage difference between the left and right testicular volumes over time, even after adjusting for factors including need for intervention. In the 14 boys with more than a 20 percent testicular size discrepancy at diagnosis who were managed conservatively, half showed acceptable catch-up growth, the investigators found.

"This knowledge leads us to question the absolute surgical indication for varicocele repair stating that a testicular size differential of greater than 20 percent requires repair. Instead, our study indicates the need for close follow-up with serial ultrasound measurements to catch those who have an increasing size differential. If the trend reveals an increasingly severe testicular asymmetry, surgery is still indicated. However, if the discrepancy is stable or improving, continued conservative management with close observation is warranted," the authors conclude.

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