青少年族群精索靜脈曲張處理對睪丸體積之影響
陳嘉宏1、范玉華1,2,3、林登龍1,2,3
台北榮民總醫院泌尿部1; 陽明大學醫學系泌尿學科 2; 書田泌尿科學研究中心3
The Effect of Varicocele Repair on Testicular Volume in Adolescent With Varicocele
Chia-Hung Chen1, Yu-Hua Fan 1,2,3, Alex Tong-Long Lin1,2,3
Department of Urology, Taipei Veterans General Hospital, Taipei , Taiwan 1; Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan 2; Shu-Tien Urological Science Research Center , Taipei, Taiwan3
Purpose:
Varicocele is defined as abnormal dilatation of the veins of the pampiniform
plexus and scrotum, and is the common genitourinary abnormality of adolescents. Reduced testicular size is often associated with varicocele. Previous studies showed that testis volume reduced is associated with poor semen analysis outcomes. Some physicians will recommend surgery. This study evaluate testis size of varicocele adolescent between surgical versus conservative management
Materials and Methods:
We retrospectively reviewed our adolescent patient with varicocele. This study included 32 boys (11 -17 year-old) with varicocele. Serial testicular volume was measured using scrotal ultrasound. Varicocelectomy will arrange if testis size more than 20% asymmetry or symptomatic. Follow-up scrotal ultrasound for testicular size were measured in both Varicocelectomy and conservative group.
Results:
Mean patient age was 14.7 years with mean testicular volume of 18 mL and 15.9 mL for right and left testicles. Average left to right testis ratio was 91.9%. Varicocelectomy was done in 14 boys (45%). Average pre-operative left to right testis ratio of Varicocelectomy group was 81%. Post-operative left to right testis ratio of Varicocelectomy group was 99.3%. Statistically significant was found for testis volume changed after surgery. (P=0.03). Average left to right testis ratio of conservative group was 96.4%. The follow-up left to right testis ratio was 94.2%. There was no significant change of left to right testis ratio in concretive group.
Conclusion:
There was significantly better growth in patient who received Varicocelectomy. Further studies are needed to report on semen analysis and fertility outcome among those patients.