[Varicocele in children and adolescents. Is surgery justified?]

Varicocele, a disease essentially observed in adults, is under-estimated in children and adolescents, in whom, for the majority of authors, the therapeutic management is surgical although the benefits in terms of fertility are unknown. Forty-eight children and adolescents, seen between 1978 and 1983, were followed by clinical examination and subsequent sperm count with a mean follow-up of 5.20 years. The presence at the first examination of the subsequent development of testicular atrophy is a pejorative element in the disease: 12% of children managed expectantly developed left testicular atrophy at puberty associated with severe anomalies of the sperm count. Persistent testicular atrophy after surgery was synonymous with anomalies of the sperm count in all of these children. Regression of moderate atrophy was observed in three children after surgical cure, but the pre and post-treatment sperm counts were normal.