Evolution of testicular asymmetry during puberty in adolescents without and with a left varicocele.

Autor: Lourdaux PJ; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium., Vaganée D; Department of Urology, Antwerp University Hospital, Edegem, Belgium.; Department of Urology, Faculty of Medicine and Health Sciences, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Wilrijk, Belgium., Leysen C; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium., De Wachter S; Department of Urology, Antwerp University Hospital, Edegem, Belgium.; Department of Urology, Faculty of Medicine and Health Sciences, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Wilrijk, Belgium., De Win G; Department of Urology, Antwerp University Hospital, Edegem, Belgium.; Department of Urology, Faculty of Medicine and Health Sciences, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Wilrijk, Belgium.
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2023 Mar; Vol. 131 (3), pp. 348-356. Date of Electronic Publication: 2022 Nov 01.
DOI: 10.1111/bju.15914
Abstrakt: Objectives: To assess the evolution of the Testicular Atrophy Index (TAI) in adolescent boys with and without a left varicocele with special attention for the currently postulated cut-off value of 20%.
Subjects and Methods: During 2015-2019, 364 adolescent boys aged 11-16 years were recruited. Genital examination and scrotal ultrasonography were repeatedly performed (≥4 month intervals). Testicular volume (TV) was calculated using the Lambert formula (length × width × height × 0.71). TAI was calculated using the formula: [(TVright - TVleft)/TVlargest (right, left)] × 100.
Results: The final study population comprised 239 participants, 161 (67.36%) controls and 78 (32.64%) adolescent boys with left varicocele. The mean (sd) number of measurements per participant was 3.82 (1.08). A TAI of ≥20% at first measurement occurred in 9.94% and 35.90%, respectively. Of these, only 31.25% and 46.43% had a TAI of ≥20% at the last measurement, respectively. Nevertheless, the risk of ending up with a TAI of ≥20% was significantly higher if a TAI of ≥20% was recorded at first measurement (P = 0.041 and P = 0.002, respectively). The normalisation rate did not differ significantly between the groups (P = 0.182). Normalisation occurred most frequently in Tanner Stages III and IV. Normalisation was mostly (≥74%) due to catch-up growth of the left testis, in contrast to growth retardation of the right testis, in both groups. The TAI seems to be a fluctuating parameter.
Conclusion: A TAI of ≥20% is a phenomenon seen in boys with and without varicocele but is more common in boys with varicocele. Although normalisation of a high TAI is frequently seen, both adolescent boys with and without a left varicocele who have an initial TAI of ≥20% have a higher risk of a TAI of ≥20% in the future. As the TAI is a fluctuating parameter during pubertal development, it's use as indicator for varicocelectomy based on a single measurement during pubertal development is questioned.
(© 2022 BJU International.)
Databáze: MEDLINE
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