Document Detail

Incidence, Significance, and Natural History of Persistent Retrograde Venous Flow Post-Varicocelectomy in Children and Adolescents: Correlation with Catch-up Growth.
MedLine Citation:
PMID:  23473906     Owner:  NLM     Status:  Publisher    
PURPOSE: Varying incidences and levels of persistent RVF have been reported following adult and adolescent varicocelectomy but its significance remains unclear. We sought to determine the incidence and natural history of persistent flow and whether it had any affect on post-operative CUG. METHODS: We retrospectively analyzed pre- and post-varicocelectomy DDUS findings. PRF, MVD, flow quality, and varicocele grade were recorded at each visit. CUG was defined as <15% asymmetry at final visit. RESULTS: Of total 330 varicocelectomy patients (247 laparoscopic, 83 open; median age 15.4yr), 145 (44%) had residual RVF with a mean PRF of 13.3cm/sec. Of 290 with repeat DDUS (median follow-up time 2.6 yr), 124 had initial PRF <20cm/sec (43%) and only 17 had PRF ≥20cm/sec (6%). Incidence of post-varicocelectomy RVF at last visit was similar to that at initial post-op visit (49% initial vs. 48% final). Twenty of 330 boys had recurrence of palpable varicocele (grade 2 or 3); 18 boys (90%) had initial RVF. CUG was more likely in patients with no RVF and rates of CUG decreased as PRF increased. All 5 patients with initial testicular asymmetry and persistent RVF at levels >30cm/sec had continued testicular asymmetry (ie, none had CUG). CONCLUSION: RVF is frequently present post-varicocelectomy and when it does occur it almost always is associated with PRFs significantly lower than those seen in patients who are recommended for initial varicocelectomy. RVF tends to persist during follow-up at stable PRFs. Palpable recurrence and persistent asymmetry is most often associated with post-operative PRFs ≥20cm/sec.
Jason P Van Batavia; Angela M Fast; Shannon N Nees; Miguel A Mercado; Anthony Gaselberti; Kenneth I Glassberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-6
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-11     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 © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Division of Pediatric Urology, Department of Urology, Columbia University College of Physicians and Surgeons, Morgan Stanley Children's Hospital of New York - Presbyterian, New York, NY.
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