Asymptomatic postpubertal male with palpable left varicocele and subclinical right varicocele.

benefits and risks of surgery should be discussed in detail with the parents and the patient. In selected adolescents with varicoceles, semen analysis may be useful in decision-making 17 though the normal range for adolescent semen parameters is lacking. Hormonal tests may be potentially useful for evaluation of testicular function in adolescents with varicocele and helpful in selecting patients for treatment. Physical exam and ultrasound characteristics of right varicoceles in adolescents with left varicoceles. The effect of varicocele repair on testicular volume in children and adolescents with varicocele. A, et al. Peak retrograde flow: a novel predictor of persistent, progressive and new onset asymmetry in adolescent varicocele. et al. Relationship of varicocele grade and testicular hypotrophy to semen parameters in adolescents. Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study. Is it worthwhile to operate on subclinical right varicocele in patients with grade II‑III varicocele in the left testicle? Efficacy of bilateral and left varicocelectomy in infertile men with left clinical and right subclinical varicoceles: a comparative study. A, et al. Is the comparison of a left varicocele testis to its contralateral normal testis sufficient in determining its well‑being? The adolescent varicocele: the crucial role of hormonal tests in selecting patients with testicular dysfunction. With the widespread use of scrotal ultrasonography, more and more subclinical right varicoceles have been detected in postpubertal males with palpable left-sided varicocele. 1 A significant relationship between testicular growth arrest and adolescent varicocele grades has been documented, 2 thus indicating that a decrease in semen quality might occur later in life. 3 On the other hand, the benefits of surgical treatment in all adolescents with varicocele remain equivocal. 4,5 Besides symptomatic adolescent varicocele, ipsilateral testis growth arrest is an acceptable treatment indication. Traditionally, testicular growth arrest will be confirmed when ipsilateral testis is 20% smaller compared to the other side. In such cases, a treatment is recommended. 6 However, there is no consensus on the definition of significant testicular hypotrophy. A range from 10% to 20% is described by different authors as a significant testicular size discrepancy. There is still controversy about the value to repair isolated subclinical varicocele in infertile adults, 9 and the meaning of repairing subclinical varicocele at pediatric age is even more debatable. In adolescents with palpable left varicocele and subclinical right varicocele, when there is obvious testicular asymmetry, we recommend bilateral varicocelectomy based …