청소년 덩굴정맥류에서 고환정맥묶음술 후 환측 고환의 따라잡기 성장

Abstract

Purpose After adolescent varicocelectomy, there is a lack of standards for the follow-up and evaluation of the catch-up growth. We investigated the time to achieve catch-up growthaccording to the difference in testicular volume as compared to the contralateral testis.

Materials and Methods From 1997 to 2004, 51 patients with at least a 1cc difference in testicular volume, as compared to the contralateral testis, and for whom the follow up was longer than 6 months were the subjects of this study. Testicular volume was measured using a Prader orchidometer and catch-up growth was defined as the equalization of testicular volume to the contralateral testis. The time to catch-up growth was investigated.

Results 47 of 51 patients had a GIII varicocele and 4 had a GII varicocele. The mean difference in testicular volume was 2.9±1.8cc. Catch-up growth was noted in 33 (64.7%) and the mean time to catch-up growth was 14.7 months. Catch-up growth occurred in 52.2%, 67.8 and 74.3% of the patients at 1, 2 and 3 years, respectively (the Kaplan-Meier). The time to catch-up growth was significantly shorter in those with a testicular volume difference of less than 3cc prior to operation (p=0.02, the log-rank test). There was no significant difference according to the age when surgery was performed (<12 years vs. ≥12 years, p>0.05, the log-rank test).

Conclusions Catch-up growth following varicocelectomy in adolescents can be expected in about 65% of patients and this occurs within 2 years for most patients. The preoperative testicular volume difference is associated with the speed of the catch-up growth. However, whether recovery of testicular volume means recovery of testicular function needs further study.