Background and aims Availability of a diagnostic algorithm for this condition is made extremely important by the unfavourable prognosis of the consequences of varicocele, as well as the fact that it is diagnosed mainly in young people and schoolchildren and can eventually lead to infertility. The aim of study was to define criteria of blood-testis barrier impairment before and after surgical treatment in children with varicocele; to investigate the correlations between inhibin B, claudin 11, and scrotal ultrasound examination (US) before and after surgical treatment of varicocele; to evaluate the long-term effect of varicocele surgery on the state of the blood-testis barrier.
Methods The study included 50 boys with varicocele aged 11 years to 17 years and 11 months. The control group consisted of 30 boys without andrological disorders in the age range of 11 years to 17 years and 11 months. Study methods included scrotal ultrasound and determination of preoperative and postoperative serum inhibin B and antisperm antibody (AsAb) concentrations and titres of the protein claudin 11.
Results Preoperative findings: decreased volumes of the left (7.4±3.65 cm3, control: 13.5±1.03 cm, p<0.05) and right (10.6±3.67 cm3, control: 13.3±0.73 cm3, p<0.05) testes. At 6 months after surgery, the testicular volumes were higher: 13.1±3.07 cm3 (p=0.038) on the left and 15.1±3.34 cm3 (p<0.05) on the right. The resistance index (RI) in the blood vessels of the left testis (0.51±0.06) was lower than in the control group (p=0.025). At 6 months post surgery, a statistically significant increase (0.55±0.02, p=0.002) was observed in the RI value in most patients with varicocele (87). The AsAb test was negative in all study subjects. A direct relationship was observed between the inhibin B concentration and the testicular volume (rs=0.56, p=0.018 for the left and rs=0.72, p=0.02 for the right testis) in the late postoperative period. A positive correlation was obtained between the inhibin B concentration and the RI (rs=0.52, p=0.01). The AsAb test was negative in both study groups.
Conclusions Varicocele is a common disorder, with the highest prevalence in children and adolescents. Investigation of blood – testis barrier markers and scrotal ultrasound data in patients with varicocele is extremely important with regard to prevention of fertility problems.
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