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Effects of percutaneous varicocele repair on testicular volume: results from a 12-month follow-up

1 Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy
2 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome 00161, Italy
3 Unit of Endocrinology, Regina Elena National Cancer Institute, Rome 00144, Italy
4 Vascular and Interventional Radiology Unit, Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza - University of Rome, Rome 00161, Italy

Correspondence Address:
Daniele Gianfrilli,
Department of Experimental Medicine, Sapienza University of Rome, Rome 00161
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aja.aja_102_18

PMID: 30604693

Varicocele is a common finding in men. Varicocele correction has been advocated for young patients with testicular hypotrophy, but there is a lack of morphofunctional follow-up data. We assessed whether percutaneous treatment of left varicocele is associated with testicular “catch-up growth” in the following 12 months by retrospectively reviewing data from an electronic database of 10 656 patients followed up in our clinic between 2006 and 2016. We selected all young adults (<35 years) with left varicocele who underwent percutaneous treatment, had a minimum of 12 months' ultrasound imaging follow-up, and had no other conditions affecting testicular volume. One hundred and fourteen men (mean±standard deviation [s.d.] of age: 22.8 ± 5.4 years) met the inclusion and exclusion criteria. Left testicular hypotrophy (LTH), defined as a ≥20% difference between left and right testicular volume at baseline, was observed in 26 (22.8%) men. Participants with LTH (mean±s.d.: 14.5 ± 2.7 ml) had lower baseline testicular volume compared to those without LTH (mean±s.d.: 15.7 ± 3.8 ml; P = 0.032). Repeated measures mixed models showed a significant interaction between LTH and time posttreatment when correcting for baseline left testicular volume (β = 0.114, 95% confidence interval [CI]: 0.018–0.210, P = 0.020), resulting in a catch-up growth of up to 1.37 ml per year (95% CI: 0.221–2.516). Age at intervention was also associated with reduced testicular volume (−0.072 ml per year, 95% CI: −0.135–−0.009; P = 0.024). Percutaneous treatment of left varicocele in young adults with LTH can result in catch-up growth over 1 year of follow-up. The reproductive and psychological implications of these findings need to be confirmed in longer and larger prospective studies.

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