Login to Access Video or Poster Abstract: MP66-13
Sources of Funding: None

Introduction

The adolescent varicocele poses several intriguing conundrums regarding the management and treatment of the varicocele. Correlations do exist between testicular hypotrophy and altered semen parameters; however, currently we have limited methods helping guide us as when to intervene or surveille these patients. We posit that there may be differences in heterogeneity as seen on sonography (SG) of patients with varicoceles compared to normal testicles. _x000D_

Methods

The testes of adolescents with grade 2-3 varicoceles were compared to unaffected testes of adolescents with confirmed testicular torsion (controls). Representative static transverse sonographic images were examined using a novel program where the pixels of gray-scale SG images were transformed into a binary map to determine heterogeneity index (HI) values. Comparisons were made using T-tests, paired t-tests and Pearson correlations (p<0.05). _x000D_ _x000D_

Results

We compared testes of 50 patients (mean age 17.7 years) with clinically significant varicoceles to 27 control testes. There was no significant difference in HI between the right and left testes of varicocele patients (p=0.25). However, the HI's of both the right and left testis of varicocele patients were significantly different compared to controls (p<0.0001). _x000D_ _x000D_ Varicocele patients who had surgery had smaller total testis volume (p <0.0001), and lower sperm count than non-surgical patients (p < 0.006). Testis volume increased significantly after surgery (p <0 .028) entirely due to change in left testis volume (p <0.017). At presentation, HI of the right testis was negatively correlated with both right (p <0.001) and left testis volume (p < 0.001). Post-op, right testis HI was negatively correlated with right (p<0.017) and left (p<0.022) testis volume, while the left testis HI negatively correlated with left testis volume (p<0.019). _x000D_ _x000D_

Conclusions

Subtle differences in testicular heterogeneity exist in patients with varicoceles compared to normals. Moreover, we demonstrated that the unilateral process appears to affect the both testes and hence these subtle bilateral changes may correlate to global abnormal semen analysis sometimes seen in these patients. Further investigation may allow to develop a novel method to help manage and advise these patients. _x000D_ _x000D_ _x000D_ _x000D_

Funding

None