Hormonal parameters and testicular volume in children and adolescents with unilateral varicocele: preoperative and postoperative findings

Preoperative and postoperative testicular volume, serum testosterone, follicle-stimulating hormone and luteinizing hormone were determined in 25 patients 8 to 19 years old (mean age 13.2 +/- 1.63) with grades 2 and 3 unilateral varicocele. Testicular growth arrest was considered significant when volume loss was greater than 2 ml. in the ipsilateral testis compared to the contralateral side. Baseline serum testosterone, follicle-stimulating hormone and luteinizing hormone as well as post-gonadotropin releasing hormone stimulation were determined preoperatively and at 4 to 6 months postoperatively. Data are presented as mean plus or minus standard deviation. Results showed an increase in serum testosterone in Tanner's stages 1 (p < 0.028) and 2 to 3 (p < 0.008). No differences were recorded in basal luteinizing hormone and follicle-stimulating hormone, as well as maximal follicle-stimulating hormone levels before and after surgery. A decrease of maximal luteinizing hormone response to gonadotropin releasing hormone test was noted postoperatively in pubertal stages 4 to 5, when compared to preoperative values. Postoperative ipsilateral testicular volume increased in all Tanner stages (p < 0.045, p < 0.008 and p < 0.012, respectively). Our observations suggest that varicocele may be initially responsible for interstitial dysfunction with preservation of germinal function and unilateral testicular growth arrest, however reversible, after pubertal surgical correction. This study supports previous reports suggesting that varicocelectomy in children who show anatomic and functional changes is advisable.