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90
29
th
CONGRESS OF THE ESPU
14:58–15:01
S10-4 (PP)
HOW TO DEFINE RECURRENCE AFTER ADOLESCENCE
VARICOCELE REPAIR? WHAT IF THEY STILL HAVE
RETROGRADE FLOW POSTOPERATIVELY?
Perviz HAJIYEV
1
, Onur TELLI
2
, Baris ESEN
3
, Aykut AKINCI
3
, Eriz OZDEN
4
, Vahid
SOLAK
3
, Tarkan SOYGUR
1
and Berk BURGU
1
1) Ankara University- School of Medicine, Paediatric Urology, Ankara, TURKEY - 2) Lütfi Kirdar Training and Research
Hospital, Paediatric Urology, Ankara, TURKEY - 3) Ankara University- School of Medicine, Urology, Ankara, TURKEY -
4) Ankara University- School of Medicine, Radiology, Ankara, TURKEY
PURPOSE
There is no definition of adolescence varicocele recurrence after surgery. We aimed to evaluate the
presence of retrograde flow and if present the Peak Retrograde Flow (RPF) after varicocelectomy
in adolescents. We also investigated its relation with catch-up growth, Total motile sperm count, and
potential paternity.
MATERIAL AND METHODS
The study involved 126 adolescent patients with a mean age of 13.9 years (range, 10.7 to 18 years)
who underwent subinguinal varicocelectomy between 2006–20016. Indication for surgery
was asymmetric testicular growth>20 %, PRF>35 cm/s and pain with grade 3 varicocele. Post-
operatively, patients were evaluated both clinically and sonographically for recurrence and testicular
volume. Catch-up growth was also compared in patients with significant pre-operative asymmetry
at a mean of the postoperative period of 16.3 (9–36) months. Mean follow up was 4.7 years
(1–8.2 years). At least one Semen analysis was performed in patients with Tanner V during the
follow-up period. All patients above 18 were phoned to determine the paternity for the study.
RESULTS
96 of our patients (76 %) showed catch-up growth on follow up. 56 patients (44 %) showed
PRF>20 cm/s on follow up. 35 of these patients had PRF 20–35 cm/s and 21 patients had
a PRF>35 cm/s. Catch-up growth showed statistically no significant difference between high and
low-pressure peak retrograde flow groups. TMC in patients with PFR >35 cm/s was significantly
lower. Only 4 patients out of 56 patient with a retrograde flow above 20 cm7sn reported paternity
and 1 was in the PFR >35 cm/sn group.
CONCLUSIONS
Despite the presence or absence of catch up growth, PRF above 35 cm/s should be taken as the
definition of recurrence after varicocelectomy in adolescents. However, this still can not properly
predict paternity.