[Andrological problems in adolescence].

The physician is consulted because of pains in the testicles or enlarged or empty scrotum, and he is primarily challenged to eliminate a possible testicular tumor. He is also questioned about the possibility of a later impairment of fertility. If severe testicular pains prevail, it usually signifies an acute testicular twist, the appearance of which every physician should be familiar with because immediate action is important--possibly an attempt of manual retorsion should be made, and most often the immediate referral to a specialist is imperative--in order to maintain the functioning of the endangered testicle. The testicular twist causes sudden testicular pains, frequently while sleeping or during sportive activities. The pain spreads into the groin region and can even lead to symptoms of shock. Frequent consequences are the disturbance of spermatogenesis. Less frequent infectious causes for testicular pains may manifest themselves as epididymitis or concomitant orchitis (parotitis epidemica). The assessment of the success of a consequent anti-infectious treatment should consider the genital symptomatology as well. Varicocele occurs almost only in the left side of the scrotum. The spermatogenesis of the left testicle is consequently often disturbed. In infertile men the varicocele is about three times more frequent than in fertile ones. If varicocele is found in adolescents, in which case it is important to compare both sides of the scrotum, the indication for a preventive surgical treatment is always impending. This question, however, is seen controversially (physiological state of transition or disease with remaining defects). We see an indication for surgical treatment also in varicocele of the adolescent boy, and not only in proven infertility of the adult male.