Widespread debate still continues among pediatric surgeons, adult urologists, andrologists, and infertility experts as to the role of an asymptomatic varicocele in the subfertility issues of a man. Herz recently suggested that even some subfertile semen parameters exist in adolescent asymptomatic varicoceles without testicular asymmetry.1 He also suggested that surgical varicocele ligation significantly improves these parameters. The exact cause of varicocele remains unknown. In prepubertal boys, a compressing malignancy, such as a Wilms’ tumor, must always be considered and an ultrasound performed. Varicoceles are classified according to a grading system of 1 to 3, with or without testicular asymmetry. It should be remembered that boys going into puberty often have asymmetrical testicular growth and this finding may be coincidental. The grade of varicocele and testicular size may rarely correlate. Several operative techniques are available for surgical varicocele ligation.2-4
KeywordsMethylene Blue Genitofemoral Nerve Testicular Vein Testicular Size Full Informed Consent
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- 1.Herz D, Dillon B. Surgical varix ligation improves occult sub-fertile semen parameters in adolescent asymptomatic varicoceles without testicular asymmetry. Presented at the Joint ESPU-AAP meeting, Uppsala, Sweden, 16–18 June 2005.Google Scholar
- 6.Laparoscopic ligation of testicular veins for varicocele in children. Poddoubnyi IV, Department of Pediatric Surgery, Russian State Medical University, Filatov Children’s Hospital #13, 15 Sadovaya-Koudrinskaya, 103001, Moscow, Russia. IPEG 2005 meeting Venice.Google Scholar