Sažetak | Objectives: To examine the hormonal levels of adolescents with varicocele, specifically
focusing on FSH, LH, and inhibin B, treated and followed at Department of Pediatric Surgery
at University Hospital of Split. We aim to determine the prevalence of normal, high, or low
levels of these hormones in the patient cohort and assess if routine hormonal tests offer any
significant diagnostic or prognostic value in the management of varicocele.
Materials and methods: This study was designed as a retrospective cohort study conducted at
the Department of Pediatric Surgery, University Hospital of Split in Croatia. All data was
collected from the hospital’s patient records between 1st of May 2015 to 1st June 2023. This
cohort study included a total of 120 participants. The data collection was exclusively extracted
from the Department of Pediatric Surgery at the University hospital of Split. Spanning from
2015 to 2021, included exclusively patients treated by a single surgeon. Exclusion criteria for
this period involved the absence of recorded LH, FSH, or Inhibin B hormonal levels. For the
period 2021 to 2023, the data was collected from the hospital’s system, including patients
treated by other surgeons as well. We recorded the patient age, FSH, LH and inhibin B hormonal
levels, and whether the patient had undergone surgery.
Results: Majority of participants have FSH, LH and Inhibin B levels within the normal
reference range. The test statistics shows that there is no significant difference in the levels of
LH;(p = 0.081) between operated and non-operated patients. However, there is statistically
significant evidence to conclude that the Inhibin B levels;(p = 0.008) were higher for the nonoperated (M=187, SD=77) than operated (M=119, SD=66) patients. There was no significant
difference in the FSH values for operated (M=5, SD=4) and non-operated patients (M=3.7,
SD=2) conditions; (p = 0.075).
Conclusions: In conclusion, this study revealed no statistically significant difference between
FSH and LH values in operated and non-operated adolescents. However, a statistically
significant difference was found between the inhibin B values in operated and non-operated.
However, those who underwent surgery were more likely to have inhibin B values in the lower
half of the spectrum compared to their non-operated counterparts. The relevance of monitoring
FSH and LH levels does not appear to influence the decision to proceed with varicocelectomy.
Further investigations should be done to determine the importance of inhibin B levels in guiding
the decision to undergo varicocelectomy. |
Sažetak (hrvatski) | Cilj: Ispitati razine hormona u adolescenata s varikokelom, s posebnim naglaskom na FSH,
LH i inhibin B, liječenih i praćenih u Klinici za dječju kirurgiju Kliničkog Bolničkog Centra
(KBC) Split. Cilj nam je bio u skupini ispitanika odrediti prevalenciju normalnih, visokih ili
niskih razina ovih hormona i procijeniti imaju li rutinski hormonski testovi značajnu
dijagnostičku ili prognostičku vrijednost u liječenju varikokele.
Materiali i metode: Ovaj rad je osmišljen kao retrospektivno kohortno ispitivanje provedeno
u Klinici za dječju kirurgiju KBC-a Split, Podatci su prikupljeni iz medicinske dokumentacije
bolesnika liječenih u razdoblju od 1. svibnja 2015. do 1. siječnja 2023. Ispitivanjem je
obuhvaćeno 120 ispitanika. Podatci prikupljeni u razdoblju od 2015. do 2021. odnose se na
bolesnike liječene od strane jednog liječnika. U istraživanje su ukjljučeni samo oni bolesnici s
nalazima LH, FSH i inhibina B. U razdoblju od 2021-2023 podatci su prikupljani iz bolničkog
informacijskog sustava te su uključeni i bolesnici drugih liječnika s istim kriterijima.
Prikupljeni su podatici o dobi bolesnika, razinama hormona FSH, LH i inhibina B te je li
bolesnik podvrgnut operaciji ili ne.
Resultati: Većina ispitanika je imala razine FSH, LH i inhibina B unutar referentnih
vrijednosti. Statistička obrada nije pokazala statistički značajnu razliku u razinama LH (p =
0.081) između operiranih i neoperiranih bolesnika. Postoji statistička značajnost za zaključak
da su razine inhibina B; (p = 0.008) bile više u neoperiranih (M=187, SD=77) od operiranih
bolesnika (M=187, SD=77). Nije bilo statističke razlike u vrijednostima FSH; (p = 0.075)
operiranih (M=5, SD=4) i neoperiranih bolesnika (M=3.7, SD=2).
Zaključak: Istraživanje nije pokazalo ststistički značajne razlike u vrijednostima FSH i LH
između operiranih i neoperiranih adolescenata. Postoji ststistički značajna razlika u
vrijednostima inhibina B operiranih i neoperiranih bolesnika. Bolesnici koji su podvrgnuti
operaciji će vjerojatnije imati vrijednosti inhibina B u donjem dijelu normalnog raspona
vrijednosti od skupine neoperiranih bolesnika. Praćenje razina FSH i LH se nije pokazalo
relevantnim u donošenju odluke o potrebi varikocelektomije. Potrebno je provesti dodatna
istraživanja kako bi se utvrdila važnost razina inhibina B u odlučivanju potrebe za
varikocelektomijom. |