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Varikozele und pubertäres Hodenwachstum

Eine prospektive Studie

Varicocele and pubertal testicular growth

A prospective study

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Zusammenfassung

Hintergrund

Der Einfluss der Varikozele auf das Hodenwachstum wurde bei Schülern der Klassen 4 und 8 prospektiv untersucht.

Teilnehmer und Methoden

Bei 778 Jungen, darunter 700 Trägern links- oder beidseitiger Varikozelen, wurde für jedes Pubertätsstadium mittels Ultraschall die Hodengröße bestimmt. Bei 257 Kindern und 287 Jugendlichen mit einseitigem Befund erfolgte ein Größenvergleich beider Hoden unter Berücksichtigung der Varikozelen- und Dopplerrefluxgrade in aufrechter und liegender Position.

Ergebnisse

Die Hodengröße nahm in der Pubertät akzentuiert zu. Ipsilaterale Volumendefizite im Jugendalter korrelierten in Rate und Ausmaß signifikant mit dem Varikozelengrad. Wachstumsunterschiede von ≥15% traten mit höherem Varikozelen- und Refluxgrad im Liegen häufiger auf.

Schlussfolgerungen

Die Varikozele kann das pubertäre Hodenwachstum hemmen. Maßgeblich für das Auftreten größerer Wachstumsdefizite ist der Grad der Varikozele und der sie begleitenden hämodynamischen Störung.

Abstract

Background

We prospectively assessed male students in the 4th and 8th forms to see whether varicoceles affect testicular growth.

Participants and methods

Ultrasound measurements were done in 778 boys to define testicular size according to the different pubertal stages. Seven hundred boys had a left or bilateral varicocele; 257 children and 287 adolescents with unilateral varicoceles were assessed for testicular size discrepancies in relationship to the varicocele size and the Doppler grades of venous reflux in the upright and supine positions.

Results

Rapid testicular growth occurred at puberty. By comparing the frequencies and extent of ipsilateral growth failures in adolescents, we noted significant differences among the varicocele grades. A volume loss of ≥15% was associated with the higher varicocele grades and the reflux grades in the supine position.

Conclusion

Varicoceles may impair testicular growth at puberty. The severity of volume loss depends on the varicocele size and the related alterations in circulatory flow.

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Abbreviations

VR:

Valsalvareflux

DR:

Dauerreflux (Dopplergrade des venösen Refluxes nach Hirsh et al.)

PHS:

Pubic hair stages (Pubertätsstadien nach Marshall u. Tanner)

Literatur

  1. Alukal JP, Zurakowski D, Atala A et al. (2005) Testicular hypotrophy does not correlate with grade of adolescent varicocele. J Urol 174: 2367–2370

    Article  PubMed  Google Scholar 

  2. Belloli G, D’Agostino S, Pesce C, Fantuz E (1993) Adolescent varicocele and other testicular anomalies: An epidemiological study. Pediatr Med Chir 15: 159–162

    PubMed  CAS  Google Scholar 

  3. Biro FM, Lucky AW, Huster GA, Morrison JA (1995) Pubertal staging in boys. J Pediatr 127: 100–102

    Article  PubMed  CAS  Google Scholar 

  4. Cartwright LM, Clement MR, Kolon TF et al. (2003) Asynchronous testicular growth in adolescent males with varicocele. J Urol 169(4) (Suppl): 268

    Article  Google Scholar 

  5. Costabile RA, Skoog S, Radovich M (1992) Testicular volume assessment in the adolescent with a varicocele. J Urol 147: 1348–1350

    PubMed  CAS  Google Scholar 

  6. Diamond DA, Paltiel HJ, DiCanzio J et al. (2000) Comparative assessment of testicular volume: Orchidometer versus ultrasound. J Urol 164: 1111–1114

    Article  PubMed  CAS  Google Scholar 

  7. El-Gohary MA (1986) Boyhood varicocele. Br J Hosp Med 35: 183–185

    PubMed  CAS  Google Scholar 

  8. Elmlinger MW, Kühnel W, Ranke MB (2002) Reference ranges for serum concentrations of lutrotopin (LH), follitropin (FSH) estradiol (E2), prolactin, progesterone, sex hormone-binding globulin (SHBG), dehydroepiandosterone sulfate (DHEAS), cortisol and ferritin in neonates, children and young adults. Clin Chem Lab Med 40: 1151–1160

    Article  PubMed  CAS  Google Scholar 

  9. Eskew LA, Watson NE, Wolfman N et al. (1993) Ultrasonographic diagnosis of varicoceles. Fertil Steril 60: 693–697

    PubMed  CAS  Google Scholar 

  10. Gjertson CK, Poon SA, Srivastava S, Shabsigh A, Glassberg KI (2006) Adolescent varicocele: What is the natural history of testicular symmetry and asymmetry? J Urol 175(4) (Suppl):163

    Google Scholar 

  11. Hadziselimovic F, Herzog B, Liebundgut B, Jenny P, Buser M (1989) Testicular and vascular changes in children and adults with varicocele. J Urol 142: 583–585

    PubMed  CAS  Google Scholar 

  12. Hienz HA, Voggenthaler J, Weissbach L (1980) Histological findings in testes with varicocele during childhood and their therapeutic consequences. Eur J Ped 133: 139–146

    Article  CAS  Google Scholar 

  13. Hirsh AV, Cameron KM, Tyler JP, Simpson JM, Pryor JP (1980) The Doppler assessment of varicoceles and internal spermatic vein reflux in infertile men. Br J Urol. 52: 50–56

    Google Scholar 

  14. Horner JS (1960) The varicocele. A survey amongst secondary school boys. Medical Officer 104: 377–381

    Google Scholar 

  15. Hornstein OP (1980) Hodenschädigung durch Varikozele. Fortschr Med 34: 1296–1300

    Google Scholar 

  16. Kass EJ, Belman AB (1987) Reversal of testicular growth failure by varicocele ligation. J. Urol 137: 475–476

    CAS  Google Scholar 

  17. Kass EJ, Chandra RS, Belman AB (1987) Testicular histology in the adolescent with a varicocele. Pediatrics 79: 996–998

    PubMed  CAS  Google Scholar 

  18. Largo RH, Prader A (1983) Pubertal development in Swiss boys. Helv Paediatr Acta 38: 211–228

    PubMed  CAS  Google Scholar 

  19. Laven JSE, Haans LCF, Willem PTM et al. (1992) Effects of varicocele treatment in adolescents: A randomized study. Fertil Steril 58: 756–762

    PubMed  CAS  Google Scholar 

  20. Lyon RP, Marshall S, Scott MP (1982) Varicocele in childhood and adolescence: Implication in adulthood infertility? Urology 19: 641–644

    Article  PubMed  CAS  Google Scholar 

  21. Manasco PK, Umbach DM, Muly SM et al. (1995) Ontogeny of gonadotropin, testosterone, and inhibin secretion in normal boys through puberty based on overnight sampling. J Clin Endicrinol Metab 80: 2046–2052

    Article  CAS  Google Scholar 

  22. Marshall WA, JM Tanner (1970) Variations in the patterns of pubertal changes in boys. Arch Dis Child 45: 13–23

    PubMed  CAS  Google Scholar 

  23. Oster J (1971) Varicocele in children and adolescents. Scan J Urol Nephrol 5: 27–32

    Article  CAS  Google Scholar 

  24. Pfeiffer D, Berger J, Schoop C, Tauber R (2006) A Doppler-based study on the prevalence of varicocele in German children and adolescents. Andrologia 38: 13–19

    Article  PubMed  CAS  Google Scholar 

  25. Steeno O, Knops J, Declerck L, Adimoelja A, van der Velde H (1976) Prevention of fertility disorders by detection and treatment of varicocele at school and college age. Andrologia 8: 47–53

    Article  PubMed  CAS  Google Scholar 

  26. Sweeny TE, Rozum JS, Desjardins C, Gore RW (1991) Microvascular pressure distribution in the hamster testis. Am J Physiol 260: 1581–1589

    Google Scholar 

  27. Tauber R, Pfeiffer D (2006) Surgical atlas varicocele: Antegrade scrotal sclerotherapy. BJU Int 98: 1333–1444

    Article  PubMed  Google Scholar 

  28. Thomas JC, Elder JS (2002) Testicular growth arrest and adolescent varicocele: Does varicocele size make a difference? J Urol 168: 1689–1691

    Article  PubMed  Google Scholar 

  29. Wyllie GG (1985) Varicocele and puberty – the critical factor? Brit J Urol 57: 194–196

    Article  PubMed  CAS  Google Scholar 

  30. World Health Organization (1993) WHO manual for the standardized investigation and diagnosis of the infertile couple, 1st ed. Cambridge University Press, Cambridge, p 20

  31. Zachmann M, Prader A, Kind HP, Häfliger H, Budliger H (1974) Testicular volume during adolescence. Helv paediatr Acta 29: 61–72

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Urologische Abteilung, Asklepios Klinik Hamburg-Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland

    D. Pfeiffer, C. Schoop & R. Tauber

  2. Zentrum für Experimentelle Medizin, Institut für Biometrie und Epidemiologie, Universitätskrankenhaus Hamburg-Eppendorf, Hamburg, Deutschland

    J. Berger

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  1. D. Pfeiffer
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  2. J. Berger
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  3. C. Schoop
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  4. R. Tauber
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Correspondence to D. Pfeiffer.

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Pfeiffer, D., Berger, J., Schoop, C. et al. Varikozele und pubertäres Hodenwachstum. Urologe 47, 59–64 (2008). https://doi.org/10.1007/s00120-007-1575-3

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