Abstract
Amaç
Bu çalışmada, adolesan yaş grubunda varikoselektomi
operasyonunun endikasyonlarının, ameliyat sonrası
etkilerinin ve komplikasyonlarının değerlendirilmesi
amaçlanmıştır.
Gereç ve Yöntem
Ocak 2010 ve Aralık 2018 tarihleri arasında 11-17
yaş aralığındaki varikoselektomi yapılan 40 hastanın
bilgileri retrospektif olarak incelendi. Hastaların demografik
verileri, şikayetleri, operasyon öyküleri, varikoselektomi
endikasyonları, fizik muayene bulguları,
semen analizleri (Tanner 5 evresinde olanlar), skrotal
renkli doppler ultrasonografi sonuçları, takip süreleri,
varikoselektomi sırasında tercih edilen anestezi türü,
varikoselektomi tarafı ve komplikasyonlar değerlendirildi.
Bulgular
Hastaların yaş ortalaması 14.2±1.8 (11-17) yıl idi. Fizik
muayenesi yapılan hastaların 36‘sında (%90) 3.
derece varikosel mevcut iken, 3 hastada (%7) varikosele
ek olarak testiküler hipoplazi, 1 hastada (%3) ise
testiküler atrofi mevcut idi. Semen analizi verebilecek
olan 4 hastanın 2’sinde semen analiz sonuçları normal
iken, 1 hastada azospermi, 1 hastada ise oligoastenospermi
saptandı. Operasyon sonrası oligoastenospermik
ve azospermik hastanın semen analizinde
düzelme izlendi. Operasyon sonrası erken dönemde
1 hastada orşit gelişirken, geç dönem takiplerde 1
hastada varikosel nüksü ve 1 hastada ise testiste hipoplazi
izlendi.
Sonuç
Varikosel testiküler hipoplazi, atrofi yaparak hipogonadizme
yol açabilen, buna ek olarak skrotal ağrıya
neden olabilen bir hastalıktır. Adolesan varikoselli
hastalar değerlendirilirken cerrahi endikasyonu olan
hastaların geciktirilmemesi oluşabilecek fertilite problemlerinden
kaçınılması açısından önemlidir.
Keywords
Supporting Institution
yok
Project Number
yok
References
- 1. Akbay E, Cayan S, Doruk E, Duce MN, Bozlu M. The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents. BJU Int. 2000;86(4):490-3.
- 2. Sigman M, Howads SS. Male Infertility. In: ‘’Campbell’s Urology 10th Edition’’.
- 3. Radmayr C, Bogaert G, Dogan HS, Kočvara R, Nijman JM, Stein R et al. Varicocele in children and adolescents Panel. EAU Guidelines on Paediatric Urology.
- 4. Kogan SJ. The pediatric varicocele In: Pediatric urology, J.P. Gearhart RC, Rink & PDE. Mouriquand, Editors. 2001; WB Saunders: philadelphia.
- 5. Ficarra V, Crestani A, Novara G, Mirone V. Varicocele repair for infertility: what is the evidence? Curr Opin Urol 2012; 22: 489–94.
- 6. Jukic M, Todoric M, Todoric J, Susnjar T, Pogorelic Z .Indian. Laparoscopic Versus Open High Ligation for Adolescent Varicocele: A 6-year Single Center Study. Pediatr. 2019;15;56 (8):653-658.
- 7. Bedir F, Keskin E, Karabakan M, Karabulut İ, Yılmazel FK, Özbey EG, et al. Evaluation of testicular catch-up growth in adolescent microsurgical varicocelectomy. Turk J Urol 2017; 43(2): 135-40
- 8. Zhou T, Zhang W, Chen Q, Li L, Cao H, Xu CL, et al. Effect of varicocelectomy on testis volume and semen parameters in adolescents: a meta-analysis. Asian J Androl. 2015;17 (6):1012-6.
- 9. Çayan S, Akbay E. Adolesan varikosel: Tanı, Tedavi, İzlem. Türk Androloji Derneği Yayını. 2004;39:478-485,
- 10. Schneck FX, Bellinger MF. Abnormalities of the testes and scrotum and their surgica management. In ‘’Campbell’s Urology 10th edition’’.
- 11. Cayan S, Acar D, Ulger S, Akbay E, et al. Adolescent varicocele repair: long-term results and comparison of surgical techniques according to optical magnification use in 100 cases at a single university hospital. J Urol. 2005; 174 (5):2003-6; discussion 2006-7
- 12. Silveri M, Adorisio O, Pane A, Colajacomo M, De Gennaro M. Subinguinal microsurgical ligation--its effectiveness in pediatric and adolescent varicocele. Scand J Urol Nephrol.2003;37(1):53-4.
- 13. Pelit ES, Yeni E. Comparative analysis of varicoselectomy techniques. Androl Bul 2018;20:85−89
Abstract
Objective
We aimed to investigate the indications, postoperative
impacts and complications of the varicocelectomy
among adolescents.
Materials and Methods
We included patients, who underwent varicocelectomy
between January 2010 and December 2018.
Forty patients’ data were analyzed retrospectively.
The demographical data, complaints, histories of any
operations, indications of varicocelectomy, physical
examination (PE) findings, semen parameters (for the ultrasonography reports, follow up durations, anesthesia
types, operation sides and complications were
recorded.
Results
The mean age of the patients was 14.2±1.8 (11-17)
years. Thirtysix (90%) of the patients had grade 3 varicocele
on PE. Three (7%) patients had testicular hypoplasia;
1 (3%) had testicular atrophy. Four patients
were able to give semen samples. Two of those had
normal results; 1 had azospermia; 1 had oligoasthenospermia.
Semen parameters of the patients with
oligoasthenospermia and azospermia improved after
operation. One patient had orchitis on early postoperative
period. Varicocele recurrence was detected in 1
patient on follow up. One patient had testicular hypoplasia
after varicocelectomy.
Conclusion
Varicocele is an ethiological factor for hypogonadism
by developing hypoplasia and atrophia. Additionally, it
is a common cause of scrotal pain. Surgery indications
should be well known during evalution of adolescents
with varicocele for avoiding fertility issues.
Project Number
yok
References
- 1. Akbay E, Cayan S, Doruk E, Duce MN, Bozlu M. The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents. BJU Int. 2000;86(4):490-3.
- 2. Sigman M, Howads SS. Male Infertility. In: ‘’Campbell’s Urology 10th Edition’’.
- 3. Radmayr C, Bogaert G, Dogan HS, Kočvara R, Nijman JM, Stein R et al. Varicocele in children and adolescents Panel. EAU Guidelines on Paediatric Urology.
- 4. Kogan SJ. The pediatric varicocele In: Pediatric urology, J.P. Gearhart RC, Rink & PDE. Mouriquand, Editors. 2001; WB Saunders: philadelphia.
- 5. Ficarra V, Crestani A, Novara G, Mirone V. Varicocele repair for infertility: what is the evidence? Curr Opin Urol 2012; 22: 489–94.
- 6. Jukic M, Todoric M, Todoric J, Susnjar T, Pogorelic Z .Indian. Laparoscopic Versus Open High Ligation for Adolescent Varicocele: A 6-year Single Center Study. Pediatr. 2019;15;56 (8):653-658.
- 7. Bedir F, Keskin E, Karabakan M, Karabulut İ, Yılmazel FK, Özbey EG, et al. Evaluation of testicular catch-up growth in adolescent microsurgical varicocelectomy. Turk J Urol 2017; 43(2): 135-40
- 8. Zhou T, Zhang W, Chen Q, Li L, Cao H, Xu CL, et al. Effect of varicocelectomy on testis volume and semen parameters in adolescents: a meta-analysis. Asian J Androl. 2015;17 (6):1012-6.
- 9. Çayan S, Akbay E. Adolesan varikosel: Tanı, Tedavi, İzlem. Türk Androloji Derneği Yayını. 2004;39:478-485,
- 10. Schneck FX, Bellinger MF. Abnormalities of the testes and scrotum and their surgica management. In ‘’Campbell’s Urology 10th edition’’.
- 11. Cayan S, Acar D, Ulger S, Akbay E, et al. Adolescent varicocele repair: long-term results and comparison of surgical techniques according to optical magnification use in 100 cases at a single university hospital. J Urol. 2005; 174 (5):2003-6; discussion 2006-7
- 12. Silveri M, Adorisio O, Pane A, Colajacomo M, De Gennaro M. Subinguinal microsurgical ligation--its effectiveness in pediatric and adolescent varicocele. Scand J Urol Nephrol.2003;37(1):53-4.
- 13. Pelit ES, Yeni E. Comparative analysis of varicoselectomy techniques. Androl Bul 2018;20:85−89
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Surgery |
| Journal Section | Research Articles |
| Authors | |
| Project Number | yok |
| Publication Date | June 15, 2021 |
| Submission Date | April 21, 2020 |
| Acceptance Date | May 20, 2020 |
| Published in Issue | Year 2021 Volume: 28 Issue: 2 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.