Varicocele and the horizontal testis: a change in position?

Area of Science:

• Pediatric Urology
• Surgical Pediatrics
• Andrology

Background:

• A horizontal lie of the testis has been observed in pediatric patients with varicoceles.
• This association was noted in six children presenting with varicoceles over a six-month period.
• All six pediatric patients exhibited an associated horizontal testicular lie.

Purpose of the Study:

• To investigate the relationship between horizontal testicular lie and varicoceles in children.
• To determine if horizontal testicular lie is a reliable indicator of pediatric varicoceles.
• To evaluate the effect of varicocele treatment on testicular position.

Main Methods:

• Observation of six pediatric patients with varicocele and horizontal testicular lie.
• Surgical intervention (high ligation of internal spermatic veins) in two cases.
• Follow-up examination of seven children who underwent high ligation for varicocele over five years.

Main Results:

• In two cases with high ligation, one patient's testis reverted to a vertical position with varicocele resolution.
• Follow-up of seven children post-high ligation showed varicocele resolution in all.
• All but one of the seven children demonstrated a vertical testicular lie post-treatment.

Conclusions:

• Horizontal testicular lie in children is a novel clinical sign.
• This sign should prompt clinicians to suspect an underlying varicocele in pediatric patients.
• Correction of varicocele may lead to the normalization of testicular position.