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Varikozele bei Jugendlichen

Varicocele in adolescents

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Zusammenfassung

Bei rund 15% aller adoleszenten Jungen findet sich eine überwiegend links lokalisierte Varikozele testis. Welchen Krankheitswert diese jedoch hat und welcher dieser Jungen tatsächlich von einer späteren Infertilität bedroht ist, ist nicht geklärt. Die Erforschung der Pathophysiologie, der Auswirkungen einer operativen oder radiologischen Therapie und potentieller Prädiktoren einer Schädigung der Spermatogenese sind nicht abgeschlossen. Die Indikation zur Therapie wird derzeit bei oft fehlender Verfügbarkeit von Ejakulatwerten v. a. an einer Differenz der Hodenvolumina festgemacht. Allerdings korrelieren die Hodenvolumina nicht zwingend mit einer späteren (In-)Fertilität, so dass dieser Surrogatparameter kritisch zu hinterfragen ist, zumal die Hälfte der Varikozelenträger in der Jugend eine Hodenvolumenzunahme ohne jede Intervention erfahren.

Abstract

Testicular varicocele is present in 15 % of adolescent boys. The very impact of this pathology and who will be at risk of developing into infertility remains unclear. Research on the pathophysiology, results of surgical or radiological interventions and potential predictors for long-term impairment of spermatogenesis and thus fertility is still ongoing. Indications for treatment are mainly based on differences in testicular volumes as semen parameters are most often not available; however, whether testicular volume is a valuable prognostic parameter for later fertility remains questionable. Approximately 50 % of adolescent patients with varicocele experience spontaneous increase of testicular volume without any intervention.

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Authors and Affiliations

  1. Abteilung für Klinische Andrologie, Centrum für Reproduktionsmedizin und Andrologie, WHO Kooperationszentrum, EAA Ausbildungszentrum, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude D11, 48149, Münster, Deutschland

    K. Czeloth &  S. Kliesch

  2. Klinik und Poliklinik für Urologie, Klinikum Fulda, Fulda, Deutschland

    T. Kälble

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  1. K. Czeloth
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  3. S. Kliesch
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Correspondence to S. Kliesch.

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Czeloth, K., Kälble, T. & Kliesch, S. Varikozele bei Jugendlichen. Urologe 52, 48–53 (2013). https://doi.org/10.1007/s00120-012-3080-6

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