Varicocele in Adolescents Guidelines

Updated: Sep 16, 2020
  • Author: James M Elmore, MD; Chief Editor: Marc Cendron, MD  more...
  • Print

European Society for Paediatric Urology Guidelines

In 2015, the European Society for Paediatric Urology (ESPU) formulated the following recommendations for management of varicocele in children and adolescents [25] :

  • There is no evidence that treatment of varicocele at pediatric age will offer a better andrologic outcome than an operation performed later
  • 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
  • For surgical ligation, some form of optical magnification (microscopic or laparoscopic magnification) should be used
  • Lymphatic-sparing varicocelectomy is preferred to prevent hydrocele formation and testicular hypertrophy