The Palomo procedure in the treatment of boys with varicocele: a retrospective study of testicular growth and fertility |
| |
Authors: | R Stern W Kistler A F Schärli |
| |
Institution: | (1) Department of Pediatric Surgery, Children's Hospital of Lucerne, Switzerland, CH |
| |
Abstract: | The Palomo procedure has often been criticized with regard to possible atrophy of the testis. Measuring the testicular volume
is mainly used in pre- and postoperative assessment. Evidence concerning fertility remains unclear. The aim of this study
was to learn whether now-adult former patients had any disturbance of their testicular growth and/or fertility. Out of 79
patients operated upon with Palomo's procedure between 1979 and 1990, 33 could be evaluated. They all had grade II or III
left-sided varicoceles. Investigations consisted of: the patient's history, testicular-volume measurement by means of an orchidometer
(OM) (Prader) and ultrasonography (US), and semen analysis (27/33) 6–17 years after surgery. No recurrence of grade II varicoceles
was observed. Only 1 of the 33 patients might have had testicular atrophy, yet he had already fathered 3 children! Twenty-three
had a normal sperm count and 24/27 showed normal sperm motility. Eight hydroceles were either present at the time of investigation
or had been operated upon in the past. Estimations of testicular volume by OM and US showed significant differences between
the two methods concerning volume and relation of right to left side. In general, the volume was overestimated by the OM.
The study shows that in boys the simple surgical technique proposed by Palomo has – in the long run – no disadvantages for
testicular development and sperm production. Fertility should therefore not be compromised.
Accepted: 8 April 1998 |
| |
Keywords: | Varicocele Palomo procedure Fertility Testicular volume |
本文献已被 SpringerLink 等数据库收录! |