RESUMO
OBJECTIVE: To study hormonal and histological parameters of paediatric-adolescent varicocele in order to know certain aspects of its natural history, in an attempt to find prognostic markers of testicular damage. DESIGN AND METHODS: In a prospective cross-sectional study, we evaluated 93 children and adolescents with left unilateral varicocele and 29 healthy males as control group. All of them were classified according to Tanner stage. Scrotal Doppler in both testes and GnRH and human chorionic gonadotrophin (hCG) tests were performed in all subjects. Surgery was performed in 28 patients and homolateral testicular biopsy in 18. RESULTS: Hormonal measurements of patients with varicocele were compared with a control group for each Tanner stage. Testicular biopsy specimens were analysed by light and electron microscopy. We only observed statistical differences in Tanner III patients in basal FSH (median and range) controls=1.70 (1.10-3.70) IU/l vs varicocele=4.20 (1.00-7.50) IU/l, P<0.05 and in Tanner IV patients in LH post-GnRH: controls=11.0 (7.50-15.0) IU/l vs varicocele=18.0 (5.10-29.0) IU/l, P<0.05 and in testosterone post-hCG: controls=9.50 (7.7-10.0) ng/ml vs varicocele=12.0 (6.2-23.0) ng/ml, P<0.01. No correlation was found between the various clinical grades of varicocele and hormonal measurements for each Tanner stage. No statistically significant differences were found between pre- and post-operative hormonal findings, either in basal levels or in maximal responses. On the other hand, no morphological abnormalities were observed by electron microscopy in germ cells, tubular wall and interstice. CONCLUSIONS: There appears to be no reliable biochemical marker in children and adolescents that may predict impaired testicular function. A significant size discrepancy between both testes, testicular pain and a hyperresponse to GnRH stimulation should continue to be, for the time being, the indications for surgery.
Assuntos
Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Varicocele/sangue , Varicocele/fisiopatologia , Adolescente , Biópsia , Criança , Gonadotropina Coriônica , Hormônio Liberador de Gonadotropina , Humanos , Células Intersticiais do Testículo/patologia , Masculino , Valores de Referência , Células de Sertoli/patologia , Espermátides/patologia , Espermatogênese , Testículo/patologia , Testosterona/sangue , Varicocele/patologiaRESUMO
Presentamos una técnica de alargamiento del paladar,en una casuística de 47 pacientes tratados en el Hospital de Agudos Carlos G Durand,durante el período comprendido entre Noviembre de 1988 a Mayo de 1999.Dicha cirugía consiste en la confección de un doble colgajo con ambas semi-úvulas,que mediante una Zetaplastia prolongan el velo del paladar,pudiendo asociar la misma a cualquier procedimiento del cierre de la fisura palatina.Consideramos que dicha técnica es una alternatoc aválida para mejorar la compentencia velo-faríngea
Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Úvula/cirurgia , Fissura Palatina , Retalhos Cirúrgicos , PediatriaRESUMO
Presentamos una técnica de alargamiento del paladar,en una casuística de 47 pacientes tratados en el Hospital de Agudos Carlos G Durand,durante el período comprendido entre Noviembre de 1988 a Mayo de 1999.Dicha cirugía consiste en la confección de un doble colgajo con ambas semi-úvulas,que mediante una Zetaplastia prolongan el velo del paladar,pudiendo asociar la misma a cualquier procedimiento del cierre de la fisura palatina.Consideramos que dicha técnica es una alternatoc aválida para mejorar la compentencia velo-faríngea
