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Adolescent Varicocele: Is the "20/38" Harbinger a Durable Predictor of Testicular Asymmetry?
MedLine Citation:
PMID:  23154205     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Part of the management of adolescents with a varicocele is trying to prognosticate who with testicular asymmetry will have CUG with observation and who will have persistent asymmetry. We previously reported that CUG is rare when PRF ≥38cm/sec is associated with ≥20% asymmetry (ie, the "20/38" harbinger). We sought to determine if this 20/38 cut-off held true with a larger series and what PRF value should be used when 15% instead of 20% asymmetry was chosen as the cut-off. METHODS: Patients from our larger varicocele registry who had at least 2 DDUS evaluations with ≥10month period of observation in between were analyzed. Outcomes were determined as regards those who met the 20/38 cut-off and what PRF value could be used to recommend surgery when 15-19.9% asymmetry is included in the asymmetry cut-off value. RESULTS: Of 355 adolescent boys with left varicocele, 44 (mean age 14.0years, range 9-20) were followed with observation initially and met the 20/38 cut-off, while another 9 met the 15/38 cutoff (initial asymmetry 15-19.9%). When combining both groups, only 3 boys had CUG to <15% on follow-up. Thus, 50 of 53 patients did not demonstrate CUG after mean follow-up of 15.5 months (range 10-44). CONCLUSION: Not only does a PRF of ≥38cm/sec hold up for predicting persistent/worsening asymmetry when combined with a 20% asymmetry cut-off, it also is an excellent predictor of persistent and/or worsening asymmetry when combined with a 15% asymmetry cut-off. Therefore, it might be unnecessary to follow an adolescent boy with observation when at or above this 15/38 cut-off.
Jason P Van Batavia; Gina Badalato; Angela Fast; Kenneth I Glassberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-12
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Division of Pediatric Urology, Morgan Stanley Children's Hospital of New York-Presbyterian, Department of Urology, Columbia University, College of Physicians and Surgeons, New York, New York.
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