Is the comparison of a left varicocele testis to its contralateral normal testis sufficient in determining its well-being?

OBJECTIVE

To determine whether a size difference between a left testis involved with a varicocele and the contralateral normal testis is sufficient in its size assessment.

METHODS

We reviewed all pediatric scrotal ultrasounds at Helen DeVos Children's Hospital between 2001 and 2008. Sonographic testicular measurements were recorded for patients with clinically diagnosed left varicocele (n = 81 for "varicocele" group) and for patients with no specific pathologic findings (n = 184 for "normal" group). We first compared the sizes between left and right testes for all patients, then between the "varicocele" group and the "normal" group separately for left and right.

RESULTS

There were no significant size differences between left and right testes for the "normal" group, whereas the left was significantly smaller than the contralateral right for the "varicocele" group (P = .0048 for length; P = .012 for volume) for all ages. For boys 16 years or older, both the left and contralateral right testes of "varicocele" boys were smaller than those of "normal" boys, adjusting for age (P for left = .026 for length and .059 for volume; for right P = .033 for length and .031 for volume).

CONCLUSION

Our study confirms that the left testis in boys with varicocele is most often smaller than the contralateral right testis no matter the age. Compared with normal boys in late adolescence, the contralateral right testis is smaller in boys with varicocele.