Abstract
The relationship of VCA to future infertility remains enigmatic. Current quidelines for surgery on VCA are based on fragmentary knowledge. In order to delineate the natural history of VCA, neccessary to establish criteria for surgery, we initiated a longitudinal study 2 years ago. Base-line data (clinical, hormonal), and data on sonography (S) are herein reported. 1395 pupils, aged 6-17 years, were examined. 111 cases of V were detected, 98% cited on the left testis. The incidence of V increased from 1.6% at age 6 years to 20.6% at age 14 and declined to 4.8% at age 17. The same trend was noted when data were expressed according to testicular volume (2-3ml:2.7%, 10-12ml:26%, 20ml:4.2%). This decline was not observed in V grade III. Values of testosterone, DHEA-S, E2 and the 60 minutes response of LH and FSH to IV LHRH did not show any difference between subjects with grade I and III V. The A volume (R-L testis) of the affected subjects, estimated with the orchidometer or S, did not differ from controls. However 20% of VII-III had A volume R-L testis > 3ml by S. Although preliminary, these date indicate that 1) The incidence of VCA is high, 2) Some V grade I and II are resolved with advancing puberty, 3) No reflexion of the V on the hormonal parameters, examined thus far, was detected, 4) No adverse effect of V on testiculargrnwth was noted in the total group. However 20% of VII-III had Δ volume R-L testis > 3ml by S, 5) The long term follow-up of V subjects will determine the natural history of V and most likely define criteria for surgery.
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Chiotis, D., Moschos, A., Papanicolaou, A. et al. 119 VARICOCELE (V) IN CHILDHOOD AND ADOLESCENCE (VCA). EFFECT ON TESTICULAR GROWTH AND HORMONAL MILIEU. Pediatr Res 24, 537 (1988). https://doi.org/10.1203/00006450-198810000-00140
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DOI: https://doi.org/10.1203/00006450-198810000-00140