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Adolescent varicocele: objective indications for treatment
E J Kass1, J E Freitas, J B Bour
1Department of Urology, Beaumont Hospital, Royal Oak, Michigan.
The Journal of Urology
|August 1, 1989
Summary
Adolescent varicoceles may cause testicular injury, affecting hormone levels. Luteinizing hormone-releasing hormone testing can reveal this dysfunction, even when physical exams appear normal.
Area of Science:
- Pediatric Endocrinology
- Reproductive Medicine
- Adolescent Urology
Background:
- Varicocele is a common condition in adolescent males.
- Potential testicular damage and hormonal imbalances are concerns.
- Predicting testicular dysfunction based on physical exam is challenging.
Purpose of the Study:
- To evaluate the gonadotropin response to luteinizing hormone-releasing hormone (LHRH) in adolescents with varicocele.
- To assess the prevalence of testicular injury indicated by hormonal response.
- To determine the utility of LHRH stimulation testing in varicocele evaluation.
Main Methods:
- Intravenous LHRH injection administered to 53 male adolescents (11-17 years) with grade II-III varicocele.
- Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone measured at baseline and 15, 30, 60 minutes post-injection.
- Analysis of gonadotropin response patterns, including exaggerated responses.
Main Results:
- Approximately 45% of adolescents with varicocele showed evidence of testicular injury via abnormal LHRH response.
- 23 patients exhibited exaggerated FSH and/or LH responses post-LHRH stimulation.
- No significant differences in age, testosterone, or testicular volume loss between normal and abnormal response groups.
Conclusions:
- Adolescents with varicocele frequently exhibit subclinical testicular injury.
- Physical examination is insufficient for predicting testicular dysfunction in these patients.
- LHRH stimulation testing is recommended as a routine diagnostic tool for adolescents with varicocele.