Nationwide survey to evaluate the prevalence of varicoceles in South Korean middle school boys: A population based study

Abstract

Objective:We carried out a nationwide epidemiological study to evaluate the prevalence and effect of varicoceles on testicular volume in South Korean adolescents. We also investigated the correlation between varicoceles and body mass index (BMI). Methods: In this prospective study, physical examinations were carried out to assess the presence and severity of varicoceles in middle school boys from six regions of South Korea. Testicular volume, height and weight of all boys were measured. The prevalence of varicoceles was assessed. The associations between age, testicular volume, BMI, and the presence and severity of varicoceles were examined. Results: A total of 1938 boys with a mean age of 14.1 years (range 13-16 years) were screened. A varicocele was found on the left side in 295 (15.2%) boys and on the right side in 8 (0.4%) boys. Bilateral varicoceles were found in 17 (0.9%) individuals. Of the subjects with a left varicocele, 151 (51.2%), 80 (27.1%) and 64 (25.1%) boys had a grade 1, 2 or 3 varicocele, respectively. The prevalence of varicoceles did not increase with age. The proportion of boys with testicular size discrepancies increased with the severity of the varicocele. After adjusting for age, BMI had a negative correlation with the presence of varicoceles. Conclusions:The prevalence of varicoceles in South Korean middle school boys is 16.5%. The presence of varicoceles seems to have a negative effect on testicular growth. BMI has a significant inverse relationship with the occurrence of varicoceles.

Varicocele prevalence in males from 7 to 26 years old and tretment outcomes

“…Slične rezultate pokazuje i korejska studija (13), gdje je u populaciji od 1938 ispitanika uzrasta od 13 do 16 godina, ljevostrana varikocela prisutna u 15,2% dječaka, pri čemu je gradus I zastupljen u 51,2% ispitanika. Pomenuta studija nije obuhvatala adolescentnu populaciju, kao ni populaciju starijih muškaraca, pri čemu se ne može dokazati rast prevalece sa godinama dječaka, što je naša studija nesumnjivo pokazala.…”

Editorial Comment from Dr Shiraishi to Nationwide survey to evaluate the prevalence of varicoceles in South Korean middle school boys: A population based study

“…3 Previously, I have also tried to carry out this kind of study in our school district, but a strong rejection was raised from the educational board of the city. I commend the authors for their important efforts and for making their work available to us for counseling the patients and parents.…”

“…All these aspects should be carefully considered by those involved in the treatment of varicocele in pediatric patients. The epidemiological investigation conducted by our institution in past years, [3][4] using the portable Doppler, showed a high incidence (48.5% including the subclinical forms) of idiopathic varicocele in the male population. I also think that subclinical varicocele should be diagnosed and monitored over several years.…”

Immunological Aspects of Varicocele

“…In grade 2, the enlargement of the venous plexus of spermatic tone is evident only by palpation at upright position. Grade 3 is visually evident and is easily diagnosed by physician [1,7]. The exact mechanism by which varicocele affects male fertility and spermatogenesis is unknown Clearly, the factors contributing to abnormal sperm function caused by varicocele that lead to infertility are ambiguous [21,22].…”

“…Primary male infertility is defined as never being able to initiate conception, whereas secondary male infertility is defined as having been able to father children in the past but currently having difficulty [3]. Varicocele is an abnormal dilation of the pampiniform venous plexus in the scrotum that develops during puberty ( Figure 1); it can affect testicular growth and semen parameters, and is considered to be a major cause of male infertility [4][5][6][7][8][9][10].…”