Varicocele in the adolescent population: challenges in management

Management of varicoceles in adolescents remain one of the most interesting and debatable topics. Although the crescent awareness of varicocele-induced testicular impairment has motivated several studies, some of the controversies in adult varicocele, regarding pathophysiology, treatment and fertility issues can also be transposed the adolescent population. Furthermore, adolescents represent a heterogenic group with challenges in diagnosis, clinical parameters, and limited predictors. Physical and pubertal development reflects in difficulties for standard management. The purpose of this article is to review available data from literature regarding the presentation, epidemiology and pathogenesis of varicocele in children and adolescents. We also address major limitations and challenges of clinical evaluation and provide current evidence regarding the dilemma of varicocele treatment in this particular subset of patients. Interventions options and outcomes are also discussed. The current review is based on an electronic search using Pubmed/MEDLINE databases and references of the identified articles performed between March and May of 2018.