KAAN SÖNMEZ, ZAFER TÜRKYILMAZ, Billur DEMİROĞULLARI, RAMAZAN KARABULUT, A. Can BAŞAKLAR, Nuri KALE

Çocukluk çağı varikosel deneyimlerimiz

Çocukluk çağı varikosel olgularının önemi ve bunlara yaklaşım erişkin erkek infertilitesinin ortaya çıkardığı bulgular ışığında giderek artmaktadır. Kendiliğinden düzelmeyen bu damarsal anomali, testis büyümesini engellemekte ve fonksiyonlarını progresif bir şekilde bozmaktadır. Adolesan dönemdeki varikosel insidansı da (% 15) dikkate alınarak kliniğimizde son 5 yılda bu konuya verilen önem giderek artmıştır. Kliniğimizde varikosel nedeniyle tedavi gören 43 (yaş ortalaması:13.5, dağılım 10-16 yaş) hastanın 33'ü (% 74) son 5 yılda, geri kalanı ise daha önceki 9 yılda ameliyat edildi. Vakaların 35'i (% 81) sol, 1'i sağ, 7'si (% 16) çift taraflıydı. 12 (% 28) vaka başka nedenli başvuraları sırasında tanı alırken, 31 vaka ise belirgin bulgu ve semptomatoloji gösteriyordu. Belirgin testiküler hacim kaybı 5 vakada saptandı. Ivanissevich tanımlamalı inguinal yaklaşım 24, Palomo'nun tanımladığı retroperitoneal yaklaşım ise 26 varikoselli tarafa uygulandı. Kliniğimizde varikosel tanısı almış hastaların asemptomatik olanlarının yüksek oranı dikkate alındığında, özellikle adolesan dönemde bu damarsal anomalinin aranması gerektiği ortaya çıkmaktadır.

Anahtar Kelimeler:

Geriyedönük çalışma, Çocuk, Ergen, Vasküler hastalıklar, Varikosel

Our experience in pediatric varicocele

Pediatric varicocele cases and aproach to this vascular anomaly has been gaining importance with regard to adult male infertility. This entity which does not resolve spontaneously has consequences of testicular growth impairment and progressive deterioration in function. Considering the high varicocele incidence during adolescence (15 %), the subject was given significance during the last 5 years in our clinic. Of the 43 patients (average age: 13.5, range: 10-16) treated for varicocele in our clinic in 14 years, 33 (74 %) has been operated in the last 5 years. Thirtyfive (81 %) cases were left, one case was right sided and 7 (16 %) were bilateral. Twentythree patients had classical sign and symptoms whereas in 12 (28 %) patients the diagnosis was reached during physical examination for other complaints than varicocele. Significant testicular volume loss was present in 5 patients. In 24 varicocele sides inguinal approach described by Ivanissevich, and in 26 retroperitoneal approach described by Palomo were applied. As the high incidence of asymptomatic patients with varicocele in our series is considered, it is perceived that this vascular anomaly must be sought for especially in adolescence.

Keywords:

Retrospective Studies, Child, Adolescent, Vascular Diseases, Varicocele,

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