Objectives: Varicoceles develop most frequently during puberty.
Book Title: Testicular Asymmetry in Healthy Adolescent Boys
Author:William Aerts
Published on 2017 by
ISBN: /
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Book is About: Testicular
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Objectives: Varicoceles develop most frequently during puberty. The influence of a varicocele on fertility in later life and the indications for surgical intervention in adolescents remain subjects of controversy. The current guidelines of the European Association of Urology (EAU) on varicocele management state that surgery is indicated when a varicocele is associated with a small testis, which is defined as a testicular size difference with the contralateral testis of \u003e 2 mL or a testicular atrophy index (TAI) \u003e20%. However, there is currently no knowledge on the distribution of testicular volume (TV) differences and TAI values in a healthy population. This study aims to get a better understanding of these values in a healthy adolescent population. Material and Methods: From April 2015 until December 2016 we recruited 539 adolescent boys aged 11 to 16 years. Each participant filled in a questionnaire and a clinical examination including testicular size measurement was performed. Testicular dimensions were measured by ultrasound and TVs were calculated using the formula of Lambert (length x width x height x 0.71). The TAI was calculated using the formula \\[(TV right - TV left)/largest TV\\]x100. Descriptive statistics were used to determine the prevalence of boys with a smaller left testis, the prevalence of boys with a TV difference (TVD) of \u003e2mL and the prevalence of boys with a TAI exceeding 20%. We used a Wilcoxon signed rank test, Kruskall-Wallis test, ANOVA, one-sample t-test and chi-square test to compare the means and prevalences of parameters for testicular differentials. Statistical analyses were performed for the entire study population as well as for each TSG. IBM SPSS Statistics 23® was used in all statistical analyses. All statistical tests were two-tailed and were conducted with type I error probability of 0.05. Results: Of the 539 recruited boys, we excluded 194 due to current or past pathology influencing normal (testicular) growth or due to incomplete data. 63 (18,26%) boys were in TSG 1, 129 (37,39%) in TSG 2, 83 (24,06%) in TSG3, 61 (17,68%) in TSG 4 and 9 (2,61%) in TSG 5. The mean TAI of the 345 included participants was 2,85% (SD 17,00%). 203 (58,84%) boys had a smaller left testis, whereas 142 (41,16%) had a smaller right testis. 45 (13,04%) boys had a TVD of 2mL or more in disadvantage of the left testis and 51 (14,78%) boys had a TAI greater than 20%. 69 (20,00%) boys had a TVD of 2mL or more in disadvantage of the left testis or a TAI greater than 20%. Related-samples Wilcoxon signed rank test showed a significant difference in left and right TV for the entire population (p\|,
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