Varicocele in Adolescents Guidelines

Updated: Aug 05, 2016
  • Author: James M Elmore, MD; Chief Editor: Marc Cendron, MD  more...
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Guidelines

European Society for Paediatric Urology

The European Society for Paediatric Urology (ESPU) formulated the following recommendations for management of varicocele in children and adolescents [24] :

  • Surgery is recommended for (1) varicocele associated with a small testis, (2) additional testicular condition affecting fertility, (3) pathologic sperm quality (in older adolescents), (4) bilateral palpable varicocele, and (5) symptomatic varicocele (level 2 evidence; grade B recommendation)
  • For surgical ligation, some form of optical magnification (microscopic or laparoscopicmagnification) should be used (level 2 evidence; grade B recommendation)
  • Lymphatic-sparing varicocelectomy is preferred to prevent hydrocele formation and testicular hypertrophy (level 2 evidence; grade A recommendation)