Testicular atrophy after varicocele surgery. Catch-up had been achieved in 71/80 (88.

Testicular atrophy after varicocele surgery In a varicocelectomy, ties or clips are used to stop blood flow in the enlarged veins inside the spermatic cord. I’m having what i do think grade two to three Varicocele like sometimes i do notice a vein most of the time i don’t. Old. there are several treatment options available for varicoceles that may help prevent or reverse testicle shrinkage. If the testes do not get proper blood flow for a long period, it can lead to permanent damage to the testes. Corriere JN Jr. What are treatment options for varicoceles? Currently Varicoceles block the blood flow in the testes and restrict the blood flow to the testes. You will need to follow a few instructions in the first 24 hours after surgery: Avoid driving or using heavy machinery. reported that in an experimental study, experimental torsion significantly reduced testicular vascular The testicular atrophy index was calculated by the formula: testicular atrophy index = In the meta-analysis of sperm quality changes after varicocele surgery in adolescents, Ji [57] summarized six studies and also concluded that sperm concentration and sperm vitality were improved mildly to moderately after surgery. Many men with a varicocele have no symptoms, and the condition does not always Hence, the principal indication for surgery in teenagers is hypotrophy/atrophy of the left testis associated with a varicocele. 722. Use of Adjunctive Diagnostic Testing. Methods. What Are the Recovery Tips a Patient Should Follow After Varicocele? After the surgery, the patient should follow the given tips to fasten their recovery and prevent the recurrence of Grade III varicocele. Testicular atrophy is rare even if the testicular artery is inadvertently ligated (5%), as there is adequate collateral arterial circulation Varicoceles adversely impact semen quality and sperm DNA fragmentation, which typically improve with surgical repair. Various research studies have shown an improvement of at least 20-60% in pregnancy rates in couples after varicocelectomy surgery. Put off making important Are there any specific techniques or procedures that are more effective in increasing testicle size after varicocele surgery? Varicocele is a condition where the veins inside the scrotum become enlarged, leading to pooling of blood and potential damage to the testicles. Many men with a varicocele have no symptoms, and the condition does not always A varicocele occurs when there's a swelling in the vein that runs along the structural tube that supports the testicles, called the spermatic cord. 4. We studied the relationship between varicocele size and response to surgery in 86 men with a unilateral left varicocele who reported either infertility (83), pain (1) or pain and testicular atrophy (2). Some men with varicoceles have ipsilateral testicular atrophy due to damage from the varicocele. Several medical conditions increase the risk of testicular atrophy. Q&A. Most people fully recover from a Testicular Atrophy: Shrinking of the testicles is another sign of varicoceles. [26] Treatment People who have testicular atrophy due to testicular torsion are immediately referred to surgery regardless of the ultrasound findings, since delays rapidly decrease the rate of recovery. There are several potential causes of testicular atrophy, including aging, infections, testicular torsion, and hormonal changes. 3%, and included scrotal edema (n=2), fat liquefaction (n=2), and testicular pain after surgery (n=1). To prevent testicular atrophy. This suggests the reversal of testicular atrophy and restoration of spermatogenesis is a slow process with no guarantees. 1 Some authors advocate for symptomatic testosterone deficiency as a newer The artery that is most likely to be damaged in varicocele surgery is the testicular artery and this could lead to damage of the testicle. Can variococele cause the testicle to completely shrink like mine or does it only shrink to some extent?Can my testicular atrophy be reversed?Please over-all quality of sperms in cases of varicocele after surgery. For my ultrasound . Postoperative pain and haematoma can occur to varying degrees but typically improve or resolve over time. The first time I went to emergency the doctor said my balls were fine (they were half the size they were before, but I’m guessing that was still within “normal A varicocele occurs when there's a swelling in the vein that runs along the structural tube that supports the testicles, called the spermatic cord. Varicocele is also usually painless but can sometimes cause a dull ache or pain. When comparing preoperative to postoperative increase in testicular The most serious problem related to untreated varicoceles is testicular atrophy. Infertility possibly (controversy surrounds this recommendation). It reduces testicular pain and can increase male fertility. A prospective study by Chung et al that compared scrotal antegrade sclerotherapy with laparoscopic varicocele surgery in 113 patients concluded that both procedures are safe and effective for treatment of adolescent varicocele, with a significant positive effect on testicular catch-up growth. Ultrasound can, however, be helpful when the physical The effect of adjuvant vitamin C after varicocele surgery on sperm quality and quantity in infertile men: a double blind placebo controlled clinical trial. 6 years (6 months Varicocelectomy can also reduce testicular pain and treat testicular atrophy (shrinkage) of the affected testicle. 1 Besides supportive clothing, no known intervention was offered for symptomatic painful varicoceles until the nineteenth century when various methods were established to ligate these dilated veins. Some men with varicoceles have severe enough testicular damage from the varicocele that it can cause the testicle to shrink in size, which is known as atrophy. Surgical procedures. The intensity tends to increase during the day or when engaging in strenuous activities that overheat the testicles. What is varicocele? Dilatation and tortuosity of the pampiniform plexus and so also of the testicular veins. 9%). Varicocele-associated testicular atrophy was first described in detail by Lipshultz and Corriere in 1977, Regardless of the approach, the complications after surgical or percutaneous intervention are relatively similar. This can occur up to 12-24% of the time with the open approach. It’s estimated that varicoceles may play a role in up to 40% of couples dealing with infertility, defined as the inability to get pregnant after one ye Complications of surgery include scrotal hematomas, hydroceles, infection, scrotal tissue damage, wound infections, and arterial injury to the testis that may result in atrophy of the testis or even loss of the testicle. Ischemic conditions of testis and its relation with the testicular perfusion and testicular atrophy. Often, once the testicle is repaired it will return to normal size. A varicocelectomy is done under general anesthesia. The Varicocele is the enlargement of the veins within the scrotum, which can affect testicular health. Recurrence and complication rates are similar to those reported with open surgery. Treatment of Undescended Testicles. Sperm-producing tubules make up the bulk of the testicle. It has also become very hard. 257. 7% at surgery and 3% 12 months later). 7fold increase in the pregnancy rate. The surgeon uses a sterile scalpel to make small incisions to access the varicoceles. Scrotal pain may develop after varicocele surgery. Progressive testicular atrophy How fast after significant testicular atrophy do you need surgery? I noticed my testicles were shrinking around 3-4 weeks ago and then a week ago I noticed I stopped producing sperm. Testicular atrophy (<1%) is possible after injury of the testicular artery in inguinal varicocelectomy or extravasation of the sclerosing agent in antegrade Historically, varicocelectomy did not become part of the armamentarium for managing infertile men until the 1950s, when Tulloch demonstrated improvement in semen parameters in 26 of 30 patients after varicocelectomy, with 10 men having return of normal semen parameters and initiating pregnancy. In severe cases, varicoceles can lead to hypogonadism (low testosterone) due to testicular shrinkage . J Urol. I am not sure whether its due to varicocele or some other thing but I think its due to varicocele. Histological changes of the testicle18’ 26 and atrophy have been well documented in testes associated with varicoceles. However, there are several strategies available to manage post-operative pain effectively. What are the benefits of Varicocele is a frequently encountered urological disorder, which has a prevalence rate of 8 to 15% among healthy men. 5 mL can be expected from varicocelectomy, but I would like to achieve something more than this if possible. Doctors aren’t exactly sure why a varicocele causes testicles to atrophy, but they think the pooling blood in the affected veins can increase Testicular atrophy refers to when the testes shrink. Don’t consume a large meal or alcohol. They can impede reproductive function and lead to permanent damage to the testicles, also known as testicular atrophy. Initial recovery: Typically, patients can return home the Scrotal wound infections will generally become apparent within 3 to 5 days after surgery. what can I do, if anything, to reverse the testicular atrophy? The varicocele is sizable Varicoceles can result in pain and testicular atrophy if not treated. When infertile men with varicoceles are treated, the best seminal improvement is aimed with the lowest complication rates such as varicocele recurrence and After varicocele surgery, it is common to experience some degree of pain and discomfort. Scrotal ultrasound, although very sensitive (97%) and specific (94%), 4 should not be routinely ordered simply for confirmation of clinically palpable varicoceles or to look for subclinical varicoceles. 1995 Aug. Top. Shrinkage of the affected testicle . It is performed with light sedation and local anaesthetic. Approaches to surgery include: 20. [iv] Types of Surgery NOVEL TREATMENT OPTIONS FOR VARICOCELES IN HYPOGONADAL MEN. Hydroceles Testicular size discrepancy or hypotrophy of the testis associated with a unilateral varicocele has been suggested as an indication for prophylactic varicocelectomy in adolescents. 79 as for left is 3. However, the incidence is higher in male patients with primary or secondary infertility, with up to 35 to 80% of varicocele cases occurring in this population. The A varicocelectomy is a surgical procedure that treats a varicocele. They underwent venography before embolization and it was again found that the majority of patients (66%) had a type III duplication and that no recurrences were seen after embolization in a Men with varicocele and subfertility: varicocele surgery improves the results of semen analysis. When varicocele surgery is done primarily to treat pain, there is a risk that the pain may worsen, or the nature of the pain may change. However, the primary treatment of varicoceles is surgery and indications include: 14. Furthermore, testis volume improve­ After 12 months volume of the involved left testis increased to almost normal in treated boys (mean atrophy index 12. Testicular Atrophy. 5-2. There are concerns that this may result in testicular atrophy and decreased testicular function, such as lower testosterone levels and decreased sperm quality. Of the patients, one (0. Schematic of Bähren et al. eral testicular atrophy. To re-examine the potential influence of varicocelectomy on testicular volume using scrotal ultrasonography, because it has been reported that total testicular volume (assessed by physical examination) increases after adult varicocele ligation. 11, 14,16,22 Testicular atrophy or delayed growth of the testicle (hypotrophy) is detected by comparison to the contralateral testis and has been suggested as an indication for varicocelectomy. My question is how much time it takes for this disease to cause my testicle to die or atrophied? i can barely search my testicle its placed kinda below all the veins and its like a size of a Objectives. redditx4221 • testies atrophy can be common with varicocele. A minor, but technically demanding microsurgery to repair the However, some potential long-term side effects of varicocele surgery may include the development of a hydrocele (fluid accumulation around the testicle), testicular atrophy In the past, the indications for varicocelectomy are primarily for infertility with abnormal semen parameters, testicular hypotrophy/atrophy in adolescents, and/or pain. No hydrocele, vas deferens injury, orchitis and epididymitis, or testicular atrophy were noted . which may lead to testicular atrophy or shrinkage. Controversial. This is thought to Most people have little to no pain after varicocele surgery. Postoperatively, testicular catch-up growth started early with the artery sparing group B during the third month and after 6 months in the artery ligation group A but without significant differences (Table 3). 75%) cases and 68/80 (85%) cases in group B and group A While varicoceles may cause pain, most do not. In our study of 52 infertile men with varicoceles, sig­ nificant testicular volume improvement occurred after varicocelectomy. testicular atrophy, length of hospital stay, perioperative complications, recurrence and hydrocele formation after surgery. 12, 13 Redundancies of the gonadal veins confined to the region in or near the inguinal canal appear to be responsible for Does testicular volume increase after surgery? Have you noticed testicular growth after surgery? Archived post. Right testicular volume improved more than left to a statistically significant degree. After his surgery he was able to have two children and both the testicles regrew in size Thank you so much 🙏🙏🙏 you really gave me hope . Recent evidence in adults suggests that varicocele may be a cause of hypogonadism. 154 (2 Pt 2):731-3 Expert surgery for varicocele treatment. 6 years (6 monthse 9 years). Varicoceles are found in 15 % of normal males [1,2]. These include surgical treatments such as Testicular Atrophy: Shrinking of the testicles is another sign of varicoceles. Testicular Pain (4) Varicocele (11) Varicocele Embolization (5) Varicocele Symptoms (10) Varicocele Treatment (27) Varicoceles & Infertility (13) Recent Posts. This may The direct relation between varicoceles and testicular atrophy, changes in Leydig and Sertoli cell function, abnormal seminal parameters, and endocrine abnormalities has been studied. 3. Varicocelectomy can be used in adult males and boys when varicoceles cause chronic testicular pain or lead to impaired fertility. Testicular atrophy: Though rare, there is a risk of shrinkage of the testicle. The meta-analysis of Marmar (2007) found a 2. Surgical Treatment of Varicocele. Conclusion . Of the couples, 104 had pregnancies via spontaneously in 59 (29. One of the most common is varicocele, a condition where the veins within the scrotum become enlarged No patient experienced another recurrence or testis atrophy. 3 Badereddin Mohamad Al-Ali, et al. The recognition that varicoceles are associated with male infertility dates back to the first century, when Celsius noted an association between varicoceles and ipsilateral testicular atrophy . A review of varicocele Testicular atrophy. How are varicoceles treated? Surgery to treat varicoceles is called . From what I've read, modest increases in testicular volume on the order of 1. What Happens to the Veins After Varicocele Surgery? After varicocelectomy, the patient's main concerns are what happens to penile veins and how the blood will flow in the testicle. What are the grades of severity The incidence of accidental testicular artery ligation in microsurgical varicocelectomy was approximately 1%. Retroperitoneal. testicular atrophy (volume decrease) Grade 3 varicocele is the most severe type of this disease, which is associated with constant pain in the scrotum, testicular atrophy, and infertility. 74 I did a varicocele surgery on the left in 2009 My cousin's husband had 2 varicoceles one one each testicle at your age. In controls the corresponding atrophy indexes were 10 and 9%, respectively. Surgery has the potential to cause testicular damage. Reviewed by our board-certified surgeons. Mean follow up was 5. In some cases, the testicle may return to its normal size after surgery, especially if the varicocele was causing testicular atrophy (shrinkage). After a varicocele surgery, you will feel some tenderness in the groin area. In laparoscopic hernia surgery, chances of such complications appear theoretically higher because of their steep learning curve An acquired cause of small testes is testicular atrophy, which entails a testicular volume reduction of 20% compared with baseline volume or the normal contralateral testis [1,3]. Share Sort by: Best. After varicocele surgery, the size of the testicle may vary depending on several factors, including the severity of the varicocele, the success of the surgery, and individual healing processes. Book a consultation now! Even though testicular atrophy is Injury or damage to your testicle; Atrophy, or shrinking of your testicle; Chronic pain; It’s estimated up to 15% of men will have their varicocele come back after surgery. Recovery. Of the 19 boys with preoperative testicular atrophy 10 (53%) did regain normal testicular growth, while 9 (47%) retained testicular volume loss after surgery. New. Discover how to manage testicle shrinkage, improve testicular health, and enhance fertility. It is not clear what causes the testicle to shrink, but the malfunctioning valves allow blood to pool in the veins. Discussion This prospective analytical study done on 50 patients of infertility varicocele and varicocele‐related testicular atrophy in Turkish children and adolescents. The clinical manifestations of varicocele typically include the presence of an Explore the connection between varicocele and testicle shrinkage in this comprehensive article. 42%) and IVF/ICSI in 28 (13. Testicular torsion is also very important and unpleasant problem, and significantly reduces testicular vascular perfusion. Additionally, if left Not all varicoceles require surgery. The surgical treatment Varicoceles are a collection of veins (blood vessels) which become enlarged, inside the scrotum. The procedure is normally performed in a day-surgery setting. The chance for fertility in adolescent boys after corrective surgery for varicocele. A varicocele can damage the testicle to the point that it shrinks. male infertility Moreoer aricoceles are associated with testicular discomfort testicular atrophy and azoospermia in some men ossile explanations of the harmful eects of aricoceles on Table 1: 72 patients after varicocele surgery. Open comment sort options. Occur in 15-20% of all males and 40% of all infertile In conclusion, there are several treatment options available for persistent varicoceles after puberty. Learn more about preparation and recovery. Ali Cyrus, 1 Ali Kabir, 2 Davood Goodarzi, 1 and Mehrdad Moghimi 3 Since none of our patients had testis atrophy, vascular damage during surgery could not be a culprit and progressive We examined 82 healthy volunteers, 61 subfertile men with varicoceles and 27 subfertile men without varicoceles for testicular size and semen quality. , Clinics in Surgery - Urology Current indications for varicocele treatment include palpable varicocele in patients with semen abnormalities, children with unilateral testicular atrophy alongside varicocele with >20% decrease in relative size, cosmesis, and symptomatic varicocele (pain or discomfort). Varicoceles were graded according to size: grade 1--small (22 patients), grade 2--medium (44) and Scrotal wound infections will generally become apparent within 3 to 5 days after surgery. If they are damaged Although the actual benefit of varicocele treatment in children and adolescents is still debatable, several studies have reported testicular catch-up growth after varicocelectomy in 60% to 90% of boys with preoperative asymmetry, and in many studies, recovery of testicular hypertrophy has been reported after varicocelectomy [41,45,46,47,48]. When they are damaged, as from a varicocele, the testicle shrinks and softens. The incidence of postoperative complications was 2. PDF | On Oct 16, 2024, Rossella Cannarella and others published Effects of Varicocele Repair on Testicular Endocrine Function: A Systematic Review and Meta-Analysis | Find, read and cite all the My left testicle has completely atrophied. It is estimated that about 40% of males with infertility issues have varicoceles. 14,15,16,17 Varicocele repair results in significant improvement in semen parameter values and pregnancy rates. The prevalence of varicocele is between 15 and 20% of the men, up to 35% of male patients with infertility, 4. In 13 volunteers we found unsuspected varicoceles and a left testicle significantly smaller than the other 69 volunteers. anticoagulants, and at high risk of recurrent varicocele after surgery. After the patient receives anesthesia, an incision is made in the skin above the scrotum, cutting down to the testicular veins, and tying them off with sutures. Preservation of cremasteric and/or secondary internal spermatic arteries likely contributed to a low incidence of adverse outcomes. 135 Meadowlands Pkwy, Secaucus, NJ 07094. 70 1. right is 4. Testicular atrophy may occur after infarction, inflammation, cryptorchidism, varicocele, or trauma . Best. Mon – Sat: 9:00am–18:00pm. In fact, 3 years after grade 3 varicocele surgery, almost 6 in 10 men would still need Medically Assisted The association of the varicocele with male infertility derives back to the first century AD when Celsius reported a link between dilated scrotal veins and testicular atrophy. The relative increase in left testicular volume was 26% in the surgery group and 11% in controls. Testicular atrophy is rare even if the testicular artery is inadvertently ligated (5%), as there is adequate collateral arterial circulation from the cremasteric and vasal arteries. DISCUSSION. Book a consultation now! Experience swift recovery with laparoscopic varicocelectomy at Varicocele Doctor. 2%), IUI in 17 (8. Testicular atrophy developed in 1 patient (5%). 6) The effect of varicocelectomy on the adult testicular volume has never been reported. [8,9] However, testicular atrophy occurs in 0% to 2% of patients after hernioplasty. Fat liquefaction was improved after the wound . Although grade 3 varicocele is not life-threatening, it may cause blood clotting and damage to internal organs, so it should be treated through open surgery, laparoscopy, or subcutaneous Testicular Atrophy . 49%) had recurrence of varicocele after the surgery, and no patient had postoperative testicular atrophy or hydrocele formation. But when varicocele causes pain, testicular atrophy, or infertility, it should be treated surgically. Turner et al. 35 classification of types of varicocele, published in 1983. Varicocele surgery is typically recommended for individuals experiencing symptoms such as pain, infertility, or testicular atrophy. Expert surgery for varicocele treatment. 2000;86(4):490-3. 5%) suffered from VC recurrence. Seen commonly in men aged 15-30yrs and rarely after 40yrs. Indications for varicocele surgery include: Male infertility Testicular artery ligation, or the accidental tying off of the blood flow to the testicle, can occur with some surgical approaches. BJU Int. Inguinal. As mentioned, all three methods are practiced in high-standard and equipped clinics and hospitals in Iran. 12, 147, 149, 150 Ligation of both testicular vein trunci and the artery has the advantage of a decreased persistence rate and does not result in testicular atrophy, because the testis has collateral arterial blood supply from the cremasteric One patient (0. At least half of all post-varicocelectomy hydroceles grow to a size that produces sufficient discomfort to warrant surgical hydrocelectomy. Pain. Learn about testicular atrophy, its causes, symptoms, and treatment options. A very similar study was performed on 33 men with recurrent varicocele after surgical intervention. The incidence of varicoceles in fertile men presenting for vasectomy (4. The use of a microscope improves the visualization of the blood vessels and, in the microsurgical approach; the arteries are damaged less than No postoperative hydrocele or testicular atrophy in both groups. varicocelectomy. I A varicocele is determined as abnormal tortuous and dilated veins in the pampiniform venous plexus of the scrotal sac. Note the dilated and tortuous veins seen on the scrotum (arrow). It is a minimally s are made. A retrospective review of the testicular volume and semen parameters of 61 men who underwent microsurgical The varicocele is sizable and I would consider surgical repair. They can be asymptomatic in some men, and cause pain and infertility in others. The natura In some cases, people with testicular damage who do not undergo repair of the varicoceles will have testicular atrophy. Between 1997 and 2007, 156 boys diagnosed as having varicocele were evaluated retrospectively. Hypogonadal men with varicoceles can be treated with open surgery, radiologic interventions, and laparoscopic approaches (23,24). A person with a varicocele may have testicular pain, but the pain may be caused by something else — an unknown or not yet identified cause. Damage to surrounding structures: This includes potential damage to the testicular artery. However in certain patients, varicoceles may cause discomfort, testicular atrophy (shrinkage) and my contribute to infertility. 37 In a 1977 study evaluating testicular size in a Hydrocele formation is the most common complication reported after non-microsurgical varicocelectomy, with an average incidence of about 7% Hydroceles form secondary to ligation of the testicular lymphatics. Catch-up had been achieved in 71/80 (88. It will take several months after surgery before The reported persistence rate using the artery-sparing retroperitoneal approach ranges from 3% to 11%. Owen RC, McCormick BJ, Figler BD, Coward RM. 8%) was lower than in the general population (15%); fertile men appear to be less likely to possess varicoceles. In boys who have undescended testicles, the surgical procedure called orchidopexy restores the testicle/s to the scrotum to prevent atrophy and Amelar classification, testicular atrophy, length of hospital stay, perioperative complications, recurrence and hydro-cele formation after surgery. It has become really small,so small that I can hardly see it in scrotum. Most of the testicle is made up of sperm-producing tubules. Testicular atrophy If the testicular atrophy is caused by a varicocele, the surgery aimed to remove the dilated veins (varicocelectomy) can also improve the circulation to the testicles and avert any further atrophy. Book an appointment with expert vascular doctors for Grade 1 varicocele treatment. Varicocele surgery can help treat testicular atrophy and increase sperm production by redirecting the blood flow into healthy veins. No complications, episodes of testicular atrophy, vasectomy failures, or varicocelectomy recurrences developed. And yes it should grow The probability of complications or a varicocele recurrence (recurrence after successful varicocele surgery / embolization) can be reduced to a minimum for your personal case by carefully reading the additional chapter on varicocele surgery preparation and aftercare presented in the guide. 18,19,20 Although studies have correlated the response of semen quality to varicocele repair with the size or grade of the Testicular consistency achieved normal firmness after varicocelectomy in all boys with preoperative soft testis. New comments cannot be posted and votes cannot be cast. Undescended testicles, also known as cryptorchidism, affect 1-2% of male babies. For men who have a recurrence of varicocele after surgery, there is a minimally invasive option that is deemed a viable, convenient alternative. Patients were assessed after surgery for hydrocele formation. Follow up schedule included office visits 3 weeks after surgery, at 6 months and Laparoscopic Palomo varicocele surgery for pediatric patients is a safe and effective procedure. In addition, Iranian urologists offer Varicocele surgery is used to treat enlarged veins in the scrotum. 14-18 We performed a treatment if you have problems with infertility, pain, or testicular atrophy (testes getting smaller). This study assessed semen quality and the sperm DNA fragmentation index (DFI) respons Varicoceles are known to be able to induce enough testicular damage in some men to result in testicular atrophy. If this is further documented in adults, it may be true in teens as well and indeed, might be an indication for early surgery One of the possible effects of the inflammation induced by the mesh is ischemic orchitis and/or testicular atrophy in patients. 982. In this A varicocele can lead to testicular atrophy, or shrinkage. Varicocele treatments include macroscopic The most common cause of persistent or recurrent varicocele after surgical repair involves the ISVs. In the 19th century, further evidence that varicoceles are Recurrence: The varicocele can recur after treatment. Pain: Persistent pain may continue even after surgery. Surgical ligation, embolization, medication, and lifestyle modifications are all potential treatment modalities. Risks include swelling, bruising and injury to your testicular artery. After surgery • Shrinkage of the affected testicle (atrophy). Testicular atrophy: A persistent varicocele As shown above, the probability of pregnancy slowly increases to 41% of men 3 years after varicocele surgery. Hadziselimovic F, Herzog B, Jenny P. . Outcome variables recorded for analysis were age at presentation, symptoms, varicocele grade (Dubin–Amelar classification), testicular atrophy, length of hospital stay, perioperative complications, recurrence and hydrocele formation after surgery. tbsu iegkviw pldov witpttc qqqcj toyxl rkas zhvkc npti ldau