UJ 35 Summer.pdf 592 | Evaluation of Inguinoscrotal Pathologies Among Adolescents With Special Empha- sis on Association Between Varicocele and Body Mass Index Cengizhan Yigitler,1 Hakan Yanardag,2 Emir Silit,3 Ahmet Sahin Alpay4 Purpose: To investigate the prevalence of inguinoscrotal pathologies among a stable population in Materials and Methods: - - Results: P = .0001) and varicocele than the older group (P P P = .0001), but P - tion regarding the somatometric features. Conclusion: Keywords: varicocele, body mass index, epidemiology, prevalence, inguinal hernia Corresponding Author: Cengizhan Yigitler, MD Gülhane Military Medical Academy, Department of Surgery, Haydarpasa Training Hospital, Usküdar, Istanbul, Turkey E-mail: cyigitler@hotmail. com Tel/Fax: +90 216 348 7880 Received June 2011 Accepted September 2011 1Gülhane Military Medical Academy, Department of Surgery, Haydarpasa Training Hospital, Usküdar, Istanbul, Turkey 2Department of Urology, Balikesir Military Hospital, Balikesir, Turkey 3Department of Radiol- ogy, Bozok University, Yozgat, Turkey 4 Department of Infectious Diseases, Izmir Military Hospital, Izmir, Turkey MISCELLANEOUS Miscellaneous 593Vol. 9 | No. 3 | Summer 2012 |U R O LO G Y J O U R N A L INTRODUCTION M -- - ity and sexual dysfunction become problematic in young treated only in highly selected cases, correction of almost all inguinoscrotal abnormalities during childhood aims avoiding potential infertility or restoration and maintenance of reproductive activity. - - ported to be as high as 15% to 20% in general population.(1) - - ters.(2-9) - candidates coming from all regions of our country after prevalence of these pathologies among adolescent popula- MATERIALS AND METHODS - ized database records obtained from applications for junior - gust 2002 through August 2009. Elected after a matricula- 2). After a 12-hour overnight fasting, their blood and urine - (internal medicine specialist, general surgeon, chest dis- ear, nose, and throat specialist, neurologist, psychiatrist, - dist) examined all the applicants. During the procedure, - geon and urologist examined and recorded together all dis- of any suspicion or doubt on diagnosis, ultrasonography, - not made. An incision scar from a previous inguinoscrotal - treated. in a health council consisted of ten specialists in order to - nal hernia, undescended testis, and varicocele. Thereafter, percentages and prevalence of detected inguinoscrotal dis- - comparison of continuous variables, such as age, height, 594 | - pendent samples t test, and multivariate logistic regression - P - RESULTS - - - - sided atrophic testis in one patient, hypospadias in one, left- and bilateral inguinal hernia in one patient. - inguinal hernia and one (0.20%) bilateral inguinal hernia Table 1. Examination results of 12581 subjects with detailed diagnoses and laterality of inguinoscrotal diseases. Health status No. (%) Healthy candidates 7754 (61.63) Patients affected with other diseases 3403 (27.05) Patients with inguinoscrotal diseases 1424 (11.32 %) Right-side Left-side Bilateral Overall (%) - Varicocele 743 (5.91) 1 729 13 750 (5.96)* + atrophic testis 1 (0.01) - 1 - - + hypospadias 1 (0.01) - 1 - - + left hydrocele 2 (0.01) 2 - - + inguinal hernia 3 (0.02) - 2 1 - Overall number of patients with varicocele (%) 750 (100) 1 (0.1) 735 (98) 14 (1.9) - Inguinal hernia 481 (3.82)† 269 202 14 485(3.85)‡ + undescended testis 1 (0.01) - 1 - - - Undescended testis 95 (0.76) 40 33 22 96 (0.76)§ - Atrophic testis 34 (0.27) 14 18 2 35 (0.28)** - Hypospadias 34 (0.27) - - - 35 (0.28)†† - Hydrocele 20 (0.16) 13 9 - 22 (0.17)‡‡ - Epididymal cyst 6 (0.05) 1 5 - 6 (0.05) - Penile curvature 1 (0.01) - - - 1 (0.01) - Mea stenosis 2 (0.01) - - - 2 (0.02) * 1 with atrophic testis, 1 with hypospadias, 2 with hydrocele, and 3 with inguinal hernia. 81 cases underwent varicocelectomy , † of those, 428 (88.9%) have had hernia surgery. ‡ 3 with varicocele, and 1 with undescended testis § 1 with inguinal hernia ** 1 with varicocele †† 1 with varicocele ‡‡ 2 with varicocele Miscellaneous 595Vol. 9 | No. 3 | Summer 2012 |U R O LO G Y J O U R N A L Prevalence of Inguinoscrotal Pathologies Among Adolescents | Yigitler et al 2 (range, 15.25 2 P = .0001). - - tients (202; 5.61%) (P - older subjects (P = .036; Table 2). - - P (P P = .22). 2 2) (P = .001). 2 - Table 2. Comparison of BMI, ISP, and varicocele by age category.* Characteristics Patients aged 16 to 18 years (n = 8775) Patients aged 19 to 23 years (n = 3806) p BMI, kg/m2 21.35 ± 1.72 21.62 ± 1.85 t = 7.97 .0001 Patients with ISP, n (%) 1019 (11.61) 405 (10.64) x2 = 2.49 .114Patients without ISP 7756 3401 Varicocele, n (%) 548 (6.60) 202 (5.61) x2 = 4.19 .041Subjects without ISP 7756 3401 Varicocele, n (%) 548 (6.25) 202 (5.31) x2 = 4.39 .036All other subjects 8227 3604 *BMI indicates body mass index; and ISP, inguinoscrotal pathology. Table 3. Comparison of subjects’ physical characteristics by presence of ISP and varicocele.* Patients’ characteristics Age, y Height, cm Weight, kg BMI, kg/m2 Overall (n = 12581) 18.17 ± 0.95 174.74 ± 4.60 65.21 ± 4.95 21.43 ± 1.77 ISP (+) (n = 1424) 18.13 ± 0.98 175.34 ± 4.77 65.49 ± 6.31 21.29 ± 1.77 ISP (-) (n = 11157) 18.18 ± 0.95 174.95 ± 4.82 65.71 ± 6.38 21.45 ± 1.76 t = 1.565; P = .118 t = 2.852; P = .004 t = 1.229; P = .22 t = 3.314; P = .001 Varicocele (+) (n = 750) 18.10 ± 0.99 175.77 ± 4.86 65.29 ± 6.24 21.13 ± 1.74 Varicocele (-) (n = 11831) 18.17 ± 0.95 174.95 ± 4.82 65.71 ± 6.38 21.46 ± 1.77 t = 2.028; P = .04 t = 4.504; P = .0001 t = 1.752; P = .08 t = 5.014; P = .0001 *BMI indicates body mass index; and ISP, inguinoscrotal pathology. 596 | 2 than varicocele or not (P = .05 for age; P = .0001 for height, and P - P The adjusted varicocele-physical characteristics odd ratios revealed similar pattern to the crude descriptive analyses. - cocele (Table 4). DISCUSSION - chological affection. These conditions, if left untreated or not treated properly, may lead to further complications and have negative impact on physical, psychological, and so- cioeconomic status of the patient himself, his family, and among a stable population in adolescent and young adult age group. - - ly scholar and military screenings, has been estimated in a (2,10,11) - cele.(2) namely regrouped for a recruitment tool. The exact etiology of varicocele has yet to be determined. incompetent venous valves in the internal spermatic veins, longer course and perpendicular insertion of left internal spermatic vein to the left renal vein, and increased intralu- minal pressure of the latter due to possible compression of are the popular arguments for the anatomic pathogenesis and left-side predominance of the varicocele.(12-14) “Nut- - tion due to compression of the duodenum in regard to nar- - teric artery. - tion of varicocele around the spermatic cord at physical examination, and thus, varicocele can be highly diagnosed (2,3) - (3) - - (4) did not consider investigating the grading of varicocele. We - Table 4. Associations between varicocele and somatometric characteristics by logistic regression analysis.* B p Exp (B) 95% Confidence interval for Exp (B) Height 0.034 .000 1.034 1.019 to 1.049 Weight -0.011 .080 0.990 0.978 to 1.001 Age -0.084 .040 0.919 0.848 to 0.996 *Hosmer-Lemeshow goodness-of-fit test of equations P > .05 Miscellaneous 597Vol. 9 | No. 3 | Summer 2012 |U R O LO G Y J O U R N A L Prevalence of Inguinoscrotal Pathologies Among Adolescents | Yigitler et al been used for detection of varicocele in this study. as in other studies.(2,3,5,6) applicants (P phenomenon or simply theory on easier detection. Over- - m2 - - - haps because of the longer course of left spermatic vein and increased hydrostatic pressure in a greater height.(6,7) study. Nielsen and associates, in a study exploring the re- erectile dysfunction.(2) - development of varicocele. While varicocele is hardly ever that the incidence of varicocele increased by about 10% for (15) The higher the age, the higher the prevalence of varico- cele. Local studies from our country reported similar results 0.15% to 3.22% among primary school and adolescent stu- dents(11,16) and as high as 10.6% in 19 to 20-year-old popu- lation.(17) Kumanov and colleagues demonstrated the close - (6) - age. - - period. Mostly seen in men, inguinal hernia is the protrusion of a - neum through the inguinal canal. Therefore, it is usually the - 10:1.(19,20) - - dren(21,22) and 3.2% among males of 20 to 22 years of age. (23) conducted on people in military service. surgeon at later period of adolescence rather than a pediatric play a role in the development of this difference. - our country.(21) (24) right- (25) - 598 | - CONCLUSION - (1) compromising his life style or not, and the prevalence of (2) varicocele, in front of all congenital male adolescent group; and (3) the prevalence of varicocele needed to detect thoroughly the relationship of varicocele and environmental conditions. ACKNOWLEDGEMENTS - proof reading. CONFLICT OF INTEREST None declared. REFERENCES 1. Jarow JP. Effects of varicocele on male fertility. Hum Reprod Update. 2001;7:59-64. 2. Nielsen ME, Zderic S, Freedland SJ, Jarow JP. Insight on pathogenesis of varicoceles: relationship of varicocele and body mass index. Urology. 2006;68:392-6. 3. Chen SS, Huang WJ. Differences in biochemical markers and body mass index between patients with and without varicocele. J Chin Med Assoc. 2010;73:194-8. 4. 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