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      Adolescent Varicocele: Are Somatometric Parameters a Cause?

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          Abstract

          Purpose

          It has been reported that varicocele is found less frequently in obese men. Accordingly, we evaluated varicocele patients and statistically analyzed the correlation between varicocele and somatometric parameters.

          Materials and Methods

          A total of 211 patients underwent surgery for varicoceles. All patients underwent history taking, physical examination, and scrotal ultrasound to determine the presence and severity of varicocele. An age-matched control group consisted of 102 patients who were found not to have varicocele according to physical examinations and scrotal ultrasound. The age, weight, height, and body mass index (BMI) of the two groups were compared. The statistical analyses were performed by use of PASW Statistics ver. 18.0. A p-value of less than 0.05 was used for statistical significance.

          Results

          In the varicocele group, the mean age, height, weight, and BMI were 29.42±14.01 years, 168.53±9.97 cm, 62.14±13.17 kg, and 21.66±3.21 kg/m 2, respectively. The distribution of varicocele grade was as follows: 103 (48.8%) grade III, 72 (34.1%) grade II, and 36 (17.1%) grade I. In the control group, the mean age, height, weight, and BMI were 30.83±17.31 years, 161.93±19.83 cm, 64.69±17.86 kg, and 24.04±3.64 kg/m 2, respectively. Analyzing these data specifically in adolescents, they showed significant differences in age, height, and BMI (p=0.000, p=0.000, and p=0.004, respectively) between two groups. There were no significant differences in somatometric parameters between patients with different grades of varicocele.

          Conclusions

          Our results showed that patients with varicoceles were significantly taller and had a lower BMI than did patients without varicoceles, especially among adolescents. Carefully designed future studies may be needed.

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          Most cited references12

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          Effects of varicocele on male fertility.

          J P Jarow (2015)
          Varicoceles are vascular lesions of the pampiniform plexus and are the most common identifiable abnormality found in men being evaluated for infertility. Despite the long history associated with varicoceles, there remains much controversy regarding their diagnosis and management. The purpose of this manuscript is to address three of the most pressing controversies: (i) the association of varicoceles with male infertility, (ii) whether varicoceles exert a progressive deleterious effect and (iii) the relationship of varicocele size and outcome following varicocele repair. The current literature is reviewed in an effort to answer these questions. Based upon this analysis, conclusions can be drawn regarding the best management of varicoceles in subfertile men, adolescents, young fertile men and men with subclinical varicoceles. Although there remain many controversies due to a paucity of data, there appears to be a significant difference between adults and adolescents with respect to a progressive deterioration of semen parameters and it is clear that subclinical varicoceles do not play a major role in male infertility.
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            The varicocele syndrome: venography determining the optimal level for surgical management.

            B Coolsaet (1980)
            The results of a retrospective study of 67 patients with scrotal varicocele on the left side are presented. By means of preoperative venography of the renal, internal spermatic and common iliac veins 3 types of varicocele could be distinguished in which the cause arises in the internal spermatic vein and/or the varicocele is caused by obstruction of the common iliac vein. Use of routine preoperative venography is essential to establish the etiology of the varicocele and its proper management.
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              Insight on pathogenesis of varicoceles: relationship of varicocele and body mass index.

              Varicoceles, present in 15% to 20% of men, are the most common abnormal finding among men presenting with infertility, yet controversy exists regarding their etiology. Anecdotal experience suggests that varicoceles are more prevalent in lean men, supporting the "nutcracker" effect of the superior mesenteric artery compressing the left renal vein over the aorta. We examined this hypothesis in a large adult population. A total of 2106 men were evaluated for infertility or erectile dysfunction from 1990 to 1996. The men were examined for the presence and severity of a varicocele. The association between age, height, body mass index, year of evaluation, and reason for consultation and the presence and severity of a varicocele was examined using logistic regression analysis. The mean age was 47 years (range 18 to 85), and the median body mass index was 26.4 kg/m2 (range 15.4 to 53.3). A varicocele was present in 398 men (18.9%). Stratified by grade, 59 (14.8%) were grade III, 155 (38.9%) were grade II, and 184 (46.2%) were grade I. The prevalence of varicoceles in the erectile dysfunction group (12.7%) was significantly less (P <0.001) than in the infertile group (32.2%). Multivariate logistic regression analysis revealed a statistically significant inverse relationship between body mass index and the presence of a varicocele. Varicoceles were less likely to be diagnosed among obese men. Although this suggests that the "nutcracker" phenomenon or other biophysical effects of increased adiposity may play a role in the pathogenesis, other factors could not be excluded as contributing to our findings.
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                Author and article information

                Journal
                Korean J Urol
                Korean J Urol
                KJU
                Korean Journal of Urology
                The Korean Urological Association
                2005-6737
                2005-6745
                August 2014
                08 August 2014
                : 55
                : 8
                : 533-535
                Affiliations
                Department of Urology, Daegu Catholic University Medical Center, Daegu, Korea.
                Author notes
                Corresponding Author: Jae Shin Park. Department of Urology, Daegu Catholic University Medical Center, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 705-718, Korea. TEL: +82-53-650-4662, FAX: +82-53-623-4660, jspark@ 123456cu.ac.kr
                Article
                10.4111/kju.2014.55.8.533
                4131082
                71553a0c-0214-48d3-b1f8-b2827a24b057
                © The Korean Urological Association, 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 September 2013
                : 06 May 2014
                Categories
                Original Article
                Pediatric Urology

                Urology
                body height,body mass index,varicocele
                Urology
                body height, body mass index, varicocele

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