For a study, researchers sought to compare and examine varicocelectomy and the reproductive markers (hormonal, semen parameters, and testicular volume) of adolescent boys with unilateral high-grade varicocele and associated ipsilateral testicular volume loss who were operated on vs those who were not during 5 years. The secondary goal was to compare the paternity rates in the different groups over time. Investigators conducted a single-center retrospective analysis of a prospectively maintained database from 2010 to 2020. All teenage boys more than 15 years old (middle and late adolescence) with grade II or III unilateral varicoceles with aberrant fertility indicators, who were operated on (Group A) or not operated on (Group B), were included in the study. Changes in the hormonal assay, sonographic assessment, semen analysis at presentation, 1st year, and 5th-year follow-up were compiled and analyzed in both groups. Telephonic or email talks between the 2 groups revealed primary paternity rates. About 110 boys (Group A – 70 boys and Group B – 40 boys) out of 182 boys referred for varicocele therapy met our inclusion criteria and were analyzed. Group A males were 16.5 years (15–18 years) old upon presentation, whereas Group B-boys were 16 years (15–18 years). Both groups had a higher prevalence of Grade III varicoceles. From the time of presentation to the 5th year follow-up, all Group A boys (operated) showed a significant improvement in reproductive markers (P<0.001). There was no substantial improvement in the fertility indicators above in Group B (boys who were not operated on). At the 5th year follow-up, Group A’s testicular catch-up growth was 92%, while Group B’s was 42%. The paternity rate in Groups A and B was 80% and 36%, respectively, after a long follow-up period. Surgical treatment of high-grade unilateral varicoceles that impaired hormonal assay, testicular volumes, and semen characteristics in adolescent boys could normalize these values, safeguarding their fertility in the long run.
Source:www.sciencedirect.com/science/article/abs/pii/S1477513121005829
