Pediatria pre prax 6/2022

Management of varicocele in children and adolescents

Varicocele is clinically defined as an abnormal dilation of the veins of the pampiniform venous plexus and the testicular veins with continuous or intermittent reflux of venous blood. Physical examination is the standard diagnostic method for detecting varicocele and ultrasonography is the primary imaging modality. Although many studies proved an existing link between varicocele and impaired fertility, only 20 % of men with varicocele are subfertile. Selection of patient who would benefit of a treatment and the best treatment option still remain matters of debate. In adolescents, there is a theoretical possibility of catch-up growth and presumably improved spermatogenesis of the affected testicle if the varicocele is treated while the testicles are still growing; whereas in adulthood, varicocelectomy allows modestly improved sperm parameters but no noticeable changes in testicular size.

Keywords: children, varicocele, pathogenesis, diagnosis, infertility, treatment