Testicular growth and gonadotrophin response associated with varicocele repair in adolescent males.

OBJECTIVE To measure testicular volume and the gonadotrophin response to gonadotrophin-releasing hormone (GnRH) stimulation in adolescents undergoing left varicocelectomy. PATIENTS AND METHODS Thirteen adolescents undergoing varicocelectomy had their testicular volume and endocrine function evaluated before and after surgery. RESULTS The initial left testicular volume was consistently smaller than the right but after surgery both increased. Baseline follicle-stimulating hormone (FSH) levels and the FSH response to GnRH stimulation increased after surgery. There were no differences in luteinizing hormone and testosterone levels, and no changes in Tanner staging. CONCLUSIONS Unilateral varicocelectomy with ipsilateral testicular atrophy results in bilateral testicular growth and increased FSH levels. In adolescent development, elevated FSH levels in conjunction with an increased response to the GnRH stimulation test represent a normal physiological response. The GnRH stimulation test cannot be used to determine which adolescent would benefit from surgical repair.