Adolescent varicocele

PURPOSE OF REVIEW: Adolescent varicocele is a common lesion which remains poorly understood. Recent research in pathophysiology and surgical management has shed new light on this increasingly diagnosed clinical entity. RECENT FINDINGS: Recent research demonstrates the potential importance of heat and oxidative stress patterns on testicular dysfunction with varicocele. The importance of testicular volume differentials as a surgical indication have been demonstrated. Surgical innovations have included artery sparing, often with microscopic magnification, and enhanced identification of lymphatics to reduce hydrocele with a laparoscopic approach. SUMMARY: Optimal management of adolescent varicocele is being clarified. A conservative, selective approach based on testicular volume differentials and semen analysis findings seems appropriate. Techniques affording artery and lymphatic sparing should be employed.