PEDIATRIC UROLOGY

The physical characteristics of young males with varicocele
Delaney DP, Carr MC, Kolon TF, Snyder HM 3rd, Zderic SA
Division of Urology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania , USA
BJU Int. 2004; 94: 624-6

• Objective: To determine if there is an association with habitus in young males with varicocele, as adolescent boys with varicoceles appear to be mostly taller and leaner than age-matched controls.
• Patients and Methods: Retrospectively reviewing our records we obtained the height and weight of 43 consecutive males (mean age 14.3 years, range 11-19) under long-term follow-up for varicocele. The body mass index (BMI), heights and weights were compared with values from the respective growth charts for boys aged 2-20 years (Center for Disease Control and Prevention), and the statistical significance of differences determined using the chi-square test.
• Results: The height and weight distributions of patients with varicocele indicated a significant deviation from normal in the 25-95th percentiles for stature and in the 25-75th for weight (P < 0.05). Deviations in BMI were insignificantly different from normal at each percentile.
• Conclusion: These results indicate that patients with varicocele are significantly taller and heavier than age-matched controls. Future studies to address the key areas identified in this study will help to further assess the distribution of the incidence of varicocele in closely defined subsets of adolescent growth and development, which may provide some insight into the cause of varicoceles.
  
  
• Editorial Comment
  The relationship between body habitus and varicocele has been a matter of conjecture. Anecdotal data suggest that patients with varicoceles are tall and thin. However, this has never previously been investigated. The authors in this study compare the heights, weights and body mass index of varicocele patients to national norms. They discovered that indeed, their varicocele patients were taller than average. They also found that their patients were heavier than normal, but that their body mass index was only slightly increased.
  This interesting observation leads to further conjecture about the cause of the adolescent varicocele. Why are these patients more likely to be tall? Conversely, are tall patients more likely to have varicoceles and if so, why? Does this have to do with the length of the spermatic vein? Does it have to do with posture or athleticism? Similarly, why are they heavier, but with a relatively normal body mass index? Is their weight increased due to muscle mass as opposed to adipose tissue? This nice descriptive study leaves more questions than it answers, but opens the door to future investigations. One wonders what other diseases might occur in patients with specific body habitus.

Dr. Barry A. Kogan
Chief and Professor of Urology and Pediatrics
Albany Medical College
Albany, New York, USA