Microsurgical varicocelectomy in pediatric and adolescent patients with varicocele: a single-center experience

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Aims: Varicoceles, which can occur in children, are known to cause male infertility, testicular pain, and testicular atrophy. Their treatment is primarily surgical—in adults, microsurgery is the standard treatment; however, in children, laparoscopic surgery is widely performed. This study aimed to evaluate the efficacy of microsurgery in patients with varicoceles aged <=18 years. Methods: The retrospective study was conducted from December 2016 to April 2025 and included male patients aged <=18 years who underwent microsurgical varicocelectomy at Yokohama City University Medical Center. The summary statistics were calculated. Results: The median age of this study’s 36 participants was 15 years, and the most common symptoms were testicular pain (25 cases) and scrotal swelling (11 cases). The mean right and left testicular volumes were 15.3 mL and 14.2 mL, respectively, with no significant difference between them (p = 0.09). There were 12 cases with a difference in testicular volume of >=2 mL or >=20% between the affected and unaffected sides. The median number of veins ligated was 11. Two arteries and the three lymphatic vessels as the median were preserved, respectively. The chief complaint—testicular pain or swelling—was resolved in all cases. Conclusion: Varicoceles can develop in childhood and may cause scrotal pain, testicular atrophy, and male infertility. Microsurgical varicocelectomy may be a safe and effective treatment option for children with varicocele.

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