Varicocele in adolescence

Easily detectable varicocele occurs in approximately 10 percent of boys during puberty, usually on the left side. Discomfort is unusual, and this condition is often unrecognized by boys and their physicians. Even when aware of the scrotal mass, adolescent males may not seek consultation; therefore detection on routine examination provides the opportunity for reassurance and planning follow-up. Varicoceles may be associated with reduced testicular volume and decreased semen quality. The favorable effects of spermatic vein ligation have been demonstrated in men with infertility. In the absence of prospective, controlled studies concerning the optimal management of asymptomatic varicocele in adolescent patients and parents may be made aware of possible subsequent infertility. At this time, adolescents with symptomatic or secondary varicocele should be considered for urologic management.