CLINICAL STUDY Controversies in the evolution of paediatric±adolescent varicocele: clinical, biochemical and histological studies

Objective: To study hormonal and histological parameters of paediatric±adolescent varicocele in order to know certain aspects of its natural history, in an attempt to find prognostic markers of testicular damage. Design and methods: In a prospective cross-sectional study, we evaluated 93 children and adolescents with left unilateral varicocele and 29 healthy males as control group. All of them were classified according to Tanner stage. Scrotal Doppler in both testes and GnRH and human chorionic gonadotrophin (hCG) tests were performed in all subjects. Surgery was performed in 28 patients and homolateral testicular biopsy in 18. Results: Hormonal measurements of patients with varicocele were compared with a control group for each Tanner stage. Testicular biopsy specimens were analysed by light and electron microscopy. We only observed statistical differences in Tanner III patients in basal FSH (median and range) controls 1:70 (1.10±3.70) IU/l vs varicocele 4:20 (1.00±7.50) IU/l, P, 0:05 and in Tanner IV patients in LH post-GnRH: controls 11:0 (7.50±15.0) IU/l vs varicocele 18:0 (5.10±29.0) IU/l, P, 0:05 and in testosterone post-hCG: controls 9:50 (7.7±10.0) ng/ml vs varicocele 12:0 (6.2±23.0