Comparison of testicular volume discrepancy and total testicular volume as predictors of semen parameters in adolescents with unilateral left varicocele.

INTRODUCTION

Varicoceles are a common correctable cause of male infertility; however, there are limited data on the management of varicoceles in the pediatric population. This study aims to investigate the association between ultrasonographic testicular volume discrepancy (TVD) and total testicular volume (TTV) with semen parameters in adolescents with unilateral left varicocele.

OBJECTIVES

The study retrospectively analyzed Tanner stage 5 males (<21 years) with unilateral left varicocele to explore the correlation of TVD and TTV with sperm concentration, motility, and total motile sperm count (TMSC). The primary objective was to determine if abnormal TVD and TTV were indicators of suboptimal semen parameters.

MATERIALS AND

METHODS

A chart review of patients from 2010 to 2022 with unilateral left varicocele was conducted. Demographic data, clinical variables, semen parameters, and testicular volumes were collected. TVD and TTV were calculated using established formulas. Statistical analyses included Wilcoxon rank sum, Fisher's exact tests, and multiple linear regression.

RESULTS

A total of 66 patients ranging from 14 to 20 years of age were included in the study, of which 25 (38 %) patients had TVD >20 % and 47 (71 %) had TTV <30 cc. TVD >20 % and TTV <30 cc were both correlated with significantly lower sperm concentration and TMSC. However, linear regression identified only TTV as a significant predictor of TMSC and sperm concentration. TTV and TVD were not found to be associated with one another.

DISCUSSION: The study provides insights into the clinical implications of TVD and TTV in pediatric varicoceles. TTV emerged as a more reliable predictor than TVD, aligning with previous studies. While limitations include the retrospective design and sample size, the findings contribute to understanding the role of testicular volumes in adolescent varicoceles.

CONCLUSIONS

In adolescents with varicoceles, TTV may be a more accurate predictor of semen parameters than TVD. The study supports the consideration of TTV in clinical decisions and identifying candidates for varicocelectomy. Further research is needed to validate these findings and establish optimal management strategies for pediatric varicoceles. The study enhances our understanding of the relationship between testicular volumes and semen parameters in this population.