Effects of varicocelectomy on testis volume and semen parameters in adolescents: a randomized prospective study.

Because the treatment of a varicocele in adolescents remains controversial, we undertook a prospective study in 51 male adolescents, aged 15-21 years, who were referred for a varicocele. Twenty-nine patients were treated with high retroperitoneal ligation of the left spermatic vein, and 22 were untreated. Eighteen healthy adolescent volunteers without a varicocele were also assessed. Testicular volume was measured using an orchiometer, and semen analyses were carried out at referral and after 1 year of follow-up. In addition, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone levels were estimated by radioimmunoassay. Both patient groups had significantly smaller testis volumes than the controls at the outset. In the follow-up, the treated patients had testis volumes similar to those of the controls. Both testes increased significantly in volume after treatment. Although semen parameters were comparable in all groups initially, sperm concentration increased significantly after treatment of the varicocele. We concluded that varicocele treatment in adolescents leads to increased testis volume and a higher sperm concentration; however, whether early treatment will improve testicular function remains to be elucidated.