WASHINGTON, DC USA (UroToday.com) - Lymphatic sparing varicocele repair in the pediatric population significantly lowers the incidence of postoperative hydrocele.
However, there was an increased risk of varicocele recurrence. Preservation of the testicular artery was associated with a higher incidence of varicocele recurrence. In those children in whom the testicular artery was not spared, there were no cases of testicular hypotrophy. In a study looking at the coexistence of hemorrhoids and saphenofemoral junction insufficiency in males with varicoceles compared to a healthy control group, a higher incidence of hemorrhoids and saphenofemoral junction insufficiency was noted in the varicocele patients compared to the controls. This data suggests that varicoceles may be a part of a systemic venous disease In boys older than 16 years of age - both the right and left testis were noted to be smaller than that noted in normal boys. The investigators indicate that presumed “catch up growth” of the left testis may actually represent right sided growth arrest.
The use of a circumcision atlas for parental instruction and guidance after pediatric ambulatory penile surgery was evaluated. The tool was shown to decrease the number of postoperative calls and was deemed useful by most parents. One third of patients with a unilateral palpable undescended testis have a contralateral patent processus. Although this was 2.5 times more likely with a left UDT, this was not statistically significant.
Discussion ensued as to whether or not correction of a contralateral asymptomatic processus vaginalis was warranted. In a comparison of congenital versus acquired UDTs, a greater percentage of children with acquired UDTs had soy only formula. Children with acquired UDTs also had a higher incidence of 2 or more exposures
Presented at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Pamela I. Ellsworth, MD, Associate Professor Surgery (Urology), Alpert Medical School of Brown University.
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