Abstract
A varicocele is defined as the abnormal dilation of the internal testicular vein and pampiniform venus plexus within the spermatic cord. If a semen analysis is not obtained from the adolescent male, in the absence of other symptoms, the main clinical indication used by many urologists to recommend repair is testicular atrophy. The varicocele may result in testicular damage in some males causing testicular atrophy with impaired sperm production and decreased Leydig cell function, while in other males the varicocele may seemingly cause no ill effects. In adult men, varicoceles are frequently present and surgically correctable, yet the measurable benefits of surgical repair are slight according to a Cochrane review. While occurring more commonly in infertile men than fertile men, only 20% of men with a documented varicocele will suffer from fertility problems. Most varicoceles found in adolescents are detected during a routine medical examination, and it is difficult to predict which adolescent presenting with a varicocele will ultimately show diminished testicular function in adolescence or adulthood. As in adults, the mainstay of treatment for varicocele in adolescents is surgical correction. However, unlike an adult varicocelectomy (the microsurgical approach is the most common), treatment for an adolescent varicocele is more often laparoscopic. Nevertheless, the goals of treatment are the same in the adolescent and adult patients. Controversy remains as to which patients to treat, when to initiate the treatment, and what type of treatment is the best. This review will present the current understanding of the etiology, diagnosis and treatment of the adolescent varicocele.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 276-281 |
| Number of pages | 6 |
| Journal | Asian Journal of Andrology |
| Volume | 18 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 1 2016 |
| Externally published | Yes |
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Keywords
- adolescent
- adult
- management
- varicocele
ASJC Scopus subject areas
- Urology
Cite this
The varicocele : Diagnostic dilemmas, therapeutic challenges and future perspectives. / Chiba, Koji; Ramasamy, Ranjith; Lamb, Dolores J.; Lipshultz, Larry.
In: Asian Journal of Andrology, Vol. 18, No. 2, 01.03.2016, p. 276-281.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The varicocele
T2 - Diagnostic dilemmas, therapeutic challenges and future perspectives
AU - Chiba, Koji
AU - Ramasamy, Ranjith
AU - Lamb, Dolores J.
AU - Lipshultz, Larry
PY - 2016/3/1
Y1 - 2016/3/1
N2 - A varicocele is defined as the abnormal dilation of the internal testicular vein and pampiniform venus plexus within the spermatic cord. If a semen analysis is not obtained from the adolescent male, in the absence of other symptoms, the main clinical indication used by many urologists to recommend repair is testicular atrophy. The varicocele may result in testicular damage in some males causing testicular atrophy with impaired sperm production and decreased Leydig cell function, while in other males the varicocele may seemingly cause no ill effects. In adult men, varicoceles are frequently present and surgically correctable, yet the measurable benefits of surgical repair are slight according to a Cochrane review. While occurring more commonly in infertile men than fertile men, only 20% of men with a documented varicocele will suffer from fertility problems. Most varicoceles found in adolescents are detected during a routine medical examination, and it is difficult to predict which adolescent presenting with a varicocele will ultimately show diminished testicular function in adolescence or adulthood. As in adults, the mainstay of treatment for varicocele in adolescents is surgical correction. However, unlike an adult varicocelectomy (the microsurgical approach is the most common), treatment for an adolescent varicocele is more often laparoscopic. Nevertheless, the goals of treatment are the same in the adolescent and adult patients. Controversy remains as to which patients to treat, when to initiate the treatment, and what type of treatment is the best. This review will present the current understanding of the etiology, diagnosis and treatment of the adolescent varicocele.
AB - A varicocele is defined as the abnormal dilation of the internal testicular vein and pampiniform venus plexus within the spermatic cord. If a semen analysis is not obtained from the adolescent male, in the absence of other symptoms, the main clinical indication used by many urologists to recommend repair is testicular atrophy. The varicocele may result in testicular damage in some males causing testicular atrophy with impaired sperm production and decreased Leydig cell function, while in other males the varicocele may seemingly cause no ill effects. In adult men, varicoceles are frequently present and surgically correctable, yet the measurable benefits of surgical repair are slight according to a Cochrane review. While occurring more commonly in infertile men than fertile men, only 20% of men with a documented varicocele will suffer from fertility problems. Most varicoceles found in adolescents are detected during a routine medical examination, and it is difficult to predict which adolescent presenting with a varicocele will ultimately show diminished testicular function in adolescence or adulthood. As in adults, the mainstay of treatment for varicocele in adolescents is surgical correction. However, unlike an adult varicocelectomy (the microsurgical approach is the most common), treatment for an adolescent varicocele is more often laparoscopic. Nevertheless, the goals of treatment are the same in the adolescent and adult patients. Controversy remains as to which patients to treat, when to initiate the treatment, and what type of treatment is the best. This review will present the current understanding of the etiology, diagnosis and treatment of the adolescent varicocele.
KW - adolescent
KW - adult
KW - management
KW - varicocele
UR - http://www.scopus.com/inward/record.url?scp=84957867956&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84957867956&partnerID=8YFLogxK
U2 - 10.4103/1008-682X.167724
DO - 10.4103/1008-682X.167724
M3 - Article
C2 - 26698233
AN - SCOPUS:84957867956
VL - 18
SP - 276
EP - 281
JO - Asian Journal of Andrology
JF - Asian Journal of Andrology
SN - 1008-682X
IS - 2
ER -