Hormonal evaluation in adolescents with varicocele

Introduction: Varicocele is one of the most frequent disease affecting the fertility potential; OBJECTIVE: the aim of this study is to assess the correlation between clinical and radiological grade of varicocele and hormonal values.

Study design: The data about adolescents with left unilateral varicocele aged between 13 and 16 years, with Tanner stage V, followed at the Authors' Institution between September 2016 and September 2019 were investigated; inclusion and exclusion criteria were created. Patients underwent standard visit, Ultrasound, Doppler velocimetry and hormonal tests (at T0 and T1). Those patients with testicular hypotrophy underwent surgery.

Results: During the study period, 75 subjects with left unilateral varicocele were enrolled; 8 patients were excluded.A total of 67 patients were then studied. Among these patients, 37 had testicular hypotrophy, while the others had normal testicular volume. There was no correlation between grade of varicocele and testicular hypotrophy (p = 0.12); among those patients with testicular hypotrophy, there was a statistical correlation with the grade of spermatic vein reflux (grade 4 vs grades 1-2-3) (p = 0.03). Focusing on hormonal values, there was a statistical significant difference between FSH levels, clinical grades of varicocele and grade of spermatic vein reflux: FSH levels were higher in patients with clinical grade 3 varicocele respect to patients with grade 1-2 varicocele and, in particular, patients with grade 3 varicocele, testicular hypotrophy and grade 4 spermatic vein reflux (14 patients) had higher FSH level respect to others (p = 0.02). After surgery there was a significant FSH reduction.

Conclusions: Our results demonstrate that higher grade of spermatic vein reflux is associated with testicular hypotrophy and higher FSH levels.