Varicocele in Children and Adolescents: A Challenge for Diagnosis and Treatment Indications

Varicocele, fertility, and paternity are terms that are frequently used in a common topic of clinical and pathologic conditions; however, any form of direct relationship has not been found. Is the high incidence and presence of a varicocele in boys, adolescents, and adults a normal variant? The hypotheses for a possible association between varicocele and fertility are based on issues such as temperature, volume, and growth of the testis, and sperm count, and indirect evidence indicating improved semen parameters after varicocele repair. However, what it comes down to, is the chance to father a child-to introduce pregnancy rather than a sperm count difference. This article highlights evidence-based findings and recent observations for a better understanding of which boys and adolescents would benefit from treatment or reassurance.