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Variations in the management of asymptomatic adolescent grade 2 or 3 left varicoceles: a survey of practitioners.

Abstract：

OBJECTIVE:Our study aims to evaluate variations in management of asymptomatic adolescent grade 2 and 3 varicoceles by pediatric urologists. SUBJECTS AND METHODS:Electronic survey of all 267 current members of AAP Urology with 74 (28%) responding. RESULTS:When managing patients with positive examination findings, 49% of surveyed practitioners use scrotal sonography as initial screening, while 38% use only manual orchidometry and 11% observation with serial examinations. If significant testicular size discrepancy is identified, 32% immediately intervene surgically, while 59% repeat measurements in 6-12 months. When no discrepancy is identified, 36.6% of practitioners discharge their patients with no follow-up, 22.5% refer to an infertility specialist, and 31% evaluate with semen analysis. Fifty-seven percent of practitioners have never sent patients for semen analysis; only 4% send >50% of patients. Of these, 52% and 27% analyzed semen at 17-18 years and 19-20 years, respectively, and 10% send for semen analysis at <17 years. CONCLUSIONS:Our survey demonstrates that there does not appear to be a consensus among pediatric urologists managing asymptomatic grade 2 and 3 varicoceles. Better understanding of which adolescent patients with varicoceles will go on to develop male infertility is necessary to identify pediatric patients who could benefit from early intervention.

journal_name

J Pediatr Urol

journal_title

Journal of pediatric urology

authors

Coutinho K,McLeod D,Stensland K,Stock JA

doi

10.1016/j.jpurol.2013.11.001

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

430-4

issue

3

eissn

1477-5131

issn

1873-4898

pii

S1477-5131(13)00310-0

journal_volume

10

pub_type

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