Based on current available r and omized controlled trials , there is low to moderate level of evidence that radiological or surgical treatment of adolescent varicocele is associated with improved testicular size/growth and sperm concentration .
BACKGROUND The prevalence of varicoceles is as high as 15 % in children and adolescents .
Optimal management of varicoceles has not been consoli date d. Options include observation , radiological intervention , or surgical varicocelectomy .
OBJECTIVE Herein , we aim to assess the outcomes of radiological and surgical interventions for varicocele in children and adolescents evaluated by RCTs .
Surgical comparison of subinguinal and high inguinal microsurgical varicocelectomy for adolescent varicocele.
OBJECTIVE To compare the surgical outcomes of subinguinal and high inguinal approaches for microsurgical varicocelectomy . METHODS A total of 81 patients with left varicocele were r and omly assigned to undergo  microsurgical left varicocelectomy by the subinguinal ( n = 41 ) or high inguinal ( n = 40 ) approach . These two techniques were compared with regard to the operative parameters , complications and testicular growth . Anatomical parameters , including the numbers and diameters of internal spermatic arteries , veins and lymphatic vessels , were recorded . RESULTS The microsurgical step was significantly shorter for the high inguinal approach compared with the subinguinal approach ( 25.5 vs 33.3 min , respectively , P < 0.01 ) . The numbers of preserved arteries and ligated veins were significantly greater and the artery size was significantly smaller for the subinguinal ( 1.6 arteries , 11.5 veins and 1.1 mm , respectively ) compared with the high inguinal approach ( 1.2 arteries , 7.3 veins and 1.3 mm ; P < 0.001 , < 0.0001 and < 0.01 , respectively ) . There was one patient with postoperative hydrocele , and three with persistent scrotal pain after treatment with the subinguinal approach . The postoperative catch-up growth rates at 24 months were 70 % and 78 % for the subinguinal and high inguinal approaches , respectively . CONCLUSIONS The microsurgical subinguinal and high inguinal approaches seem to yield similar success rates in terms of testicular growth . However , the high inguinal approach is easier to carry out , as it requires fewer divisions of veins and is associated with a larger diameter of the spermatic artery
Based on current available r and omized controlled trials , there is low to moderate level of evidence that radiological or surgical treatment of adolescent varicocele is associated with improved testicular size/growth and sperm concentration .
BACKGROUND The prevalence of varicoceles is as high as 15 % in children and adolescents .
Optimal management of varicoceles has not been consoli date d. Options include observation , radiological intervention , or surgical varicocelectomy .
OBJECTIVE Herein , we aim to assess the outcomes of radiological and surgical interventions for varicocele in children and adolescents evaluated by RCTs .