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Active surveillance of the adolescent with varicocele: predicting semen outcomes from ultrasound
- Source :
- The Journal of urology. 191(5)
- Publication Year :
- 2013
-
Abstract
- We hypothesized that active surveillance of the adolescent varicocele is not associated with a high prevalence of suboptimal semen analysis and that patients with abnormal semen analysis have smaller testicular volumes and larger volume differentials.We conducted an institutional review board approved retrospective cohort study of adolescents with a clinically detected varicocele. Patients were initially observed by serial scrotal ultrasound evaluating testicular size and differential. Semen analysis was routinely collected in Tanner V cases, around age 18 years. Prevalence of normal semen analysis parameters was calculated, and logistic regression was used to model the ability of age at presentation and testicular volume parameters to predict a normal semen analysis.A cohort of 73 patients underwent surveillance with a mean ± SD age at presentation of 15.5 ± 2.3 years. Median followup was 2.7 years, during which time subjects underwent a median of 3 scrotal ultrasounds. A low total motile count was found in 48 patients (66%). Neither age at presentation nor testicular volume differential could predict normal semen volume, density, sperm motility or total motile count. Total testicular volume from the final ultrasound predicted total motile count (p = 0.008). However, the collective observations of volume during the entire period of surveillance could not predict total motile count (p = 0.847).There is a high prevalence of suboptimal semen analysis in adolescents with a varicocele who are followed with active surveillance. Total testicular volume can predict total motile count at the end of adolescence but not throughout.
- Subjects :
- Male
endocrine system
medicine.medical_specialty
Adolescent
Urology
Varicocele
Semen
Semen analysis
urologic and male genital diseases
Logistic regression
Cohort Studies
Scrotum
Medicine
Humans
Watchful Waiting
Retrospective Studies
Ultrasonography
Gynecology
medicine.diagnostic_test
urogenital system
business.industry
Obstetrics
Retrospective cohort study
Institutional review board
medicine.disease
Prognosis
Semen Analysis
medicine.anatomical_structure
Cohort
business
Subjects
Details
- ISSN :
- 15273792
- Volume :
- 191
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- The Journal of urology
- Accession number :
- edsair.doi.dedup.....783085ffe180b51d4f9544f9f81bdb39