The therapeutic approach to adolescent varicocele

The incidence of adolescent varicocele is 15% and it might cause damage to the developing testis and subsequently even impair fertility. Adolescent varicocele is usually asymptomatic and the diagnosis is often made during routine physical examination. The precise etiology of varicocele or the mechanism by which varicocele impairs fertility is not totally elucidated. The indications for interventional treatment are still controversial, though there appears to be a consensus that treatment should be offered to adolescents suffering from meaningful reduction of the ipsilateral testicular volume. There is also an ongoing controversy regarding the preferred surgical approach and the advantages of radiographic occlusion of the spermatic veins via venography. Eventually, in adolescents who receive timely treatment, there is a recovery in testicular volume, an up-rise in serum FSH, better response to gonadotropin stimulation and ultimately improved spermatograms. Herein, we review the current relevant literature with special focus upon the controversial issues.