Introduction: The experiences of adolescents and families contending with varicocele diagnosis and treatment decision-making remain largely unknown. The objective of this ongoing qualitative study is to explore first-person attitudes and concerns among adolescents and their parents regarding varicocele diagnosis and subsequent management using a qualitative approach to elicit core themes affecting decision-making. Methods: Using an IRB-approved exploratory qualitative design, semi-structured interviews were conducted separately with adolescents diagnosed with varicoceles and their parents from 8/2022-11/2022. Purposive sampling identified eligible patients between the ages of 10-19 diagnosed with a varicocele and seen in the urology clinic who elected conservative management or surgical varicocelectomy. Seven adolescents and 12 parents were interviewed. A standardized interview script was employed to cover the following topics: potential long-term impacts of varicoceles on fertility and sexual function; varicocele-specific knowledge; family experiences with diagnosis; factors involved in decision-making; level of parent involvement; and attitudes toward semen analysis testing. Results: Semi-structured interviews revealed that care preferences, treatment-related decisional conflict, and educational resources are critical yet underutilized aspects of adolescent varicocele diagnosis and treatment. Qualitative analysis indicated: 1) fertility concerns for patients and parents are poorly addressed; 2) family discomfort with semen analysis requires sensitive, direct communication; 3) a high degree of uncertainty impacts follow up; 4) scrotal aesthetics and impact on perceived masculinity are an important consideration for patients and parents; and 5) families have limited knowledge of the condition and potential short- and long-term impacts (Table). Conclusions: This study describes previously unexamined patient and family experiences that may improve care and decision-making interventions regarding adolescent varicoceles. The perspectives gleaned can be used to guide family-centered education and informed decision-making. SOURCE OF Funding: H H Lee Research Program.
