Controversies in male adolescent health: varicocele, circumcision, and testicular self-examination.

PURPOSE OF REVIEW: The authors review three common clinical controversies encountered by primary care providers of adolescent males: management of varicoceles, the role of circumcision in the acquisition and transmission of sexually transmitted infections, and the value of teaching testicular self-examination.

RECENT FINDINGS: Recent findings in adolescent varicoceles have advanced knowledge regarding the cause of varicoceles, the mechanism by which they may lead to infertility, new screening methods, and optimal surgical management. Accumulating evidence shows circumcision to be protective against acquisition and transmission of sexually transmitted infections, and preliminary work also indicates the potential for protection against the spread of AIDS in Africa. Testicular self-examination remains an unproven screening modality that is suboptimally performed by at-risk patients.

SUMMARY: This review updates the provider on these topics and clarifies issues involved in these controversies