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Updated: Apr 15, 2026

Grade III Varicocele Surgical Treatment using Spermatic Vein-Superficial Abdominal Vein Shunt
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Prepubertal presentation of varicocele does not affect outcomes.

M P Kurtz1, I Rosoklija1, G Kringle1

  • 1Department of Urology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Hunnewell 3, Boston, MA 02115, USA.

Journal of Pediatric Urology
|April 4, 2015
PubMed
Summary

Prepubertal varicocele in boys does not appear to lead to worse outcomes compared to adolescents. This suggests that early-stage varicocele should be managed conservatively, similar to how it

Keywords:
Tanner stageTestis volume differenceVaricocele

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Area of Science:

  • Pediatric Urology
  • Andrology
  • Surgical Outcomes

Background:

  • Varicoceles in prepubertal boys are rare, with limited understanding of their natural history.
  • Historically, early surgical intervention was common, hindering longitudinal outcome assessment.

Purpose of the Study:

  • To investigate if prepubertal varicocele presentation indicates a worse prognosis compared to adolescent presentation.
  • To test the hypothesis that there is no difference in outcomes between prepubertal and adolescent boys with varicocele.

Main Methods:

  • Retrospective review of a database of boys diagnosed with left-sided varicocele (1995-2011).
  • Inclusion criteria: Tanner stage 1 or right testis volume ≤3 cc.
  • Comparison with a matched cohort of adolescent boys based on varicocele grade and testis volume disparity.

Main Results:

  • No significant differences in varicocele grade or volume differentials at presentation between cohorts.
  • Similar rates of good outcomes (absence of hypotrophy and need for surgery) were observed: 76% in prepubertal vs. 83% in adolescent boys (P=0.71).
  • Outcomes were comparable when comparing prepubertal boys with or without initial hypotrophy to matched adolescent controls.

Conclusions:

  • Prepubertal varicocele presentation does not appear to be associated with worse outcomes than adolescent presentation.
  • The study supports a conservative management approach for prepubertal varicoceles, similar to that for adolescents.
  • Further research with larger sample sizes is needed to definitively confirm these findings.