title: Prevalence and effect of varicoceles in an elderly population.
abstract: OBJECTIVE
  The prevalence of a varicocele in the adolescent and young adult populations is approximately 15%. Because other varicose veins increase in prevalence with advanced age, we hypothesized that the incidence of varicoceles in the elderly population would be greater and might affect testicular size, consistency, and function.
  
  
  METHODS
  As part of a prostate cancer screening program, we prospectively evaluated 354 men (mean age 60.7 years) by physical examination for the presence of a varicocele, testicular size, and consistency, and measured the serum testosterone level.
  
  
  RESULTS
  A varicocele was present bilaterally in 19.8% (70 of 354), left sided only in 22.0% (78 of 354), and right sided only in 1.1% (4 of 354) of patients. Decreased testosterone levels correlated with older age (P = 0.001) and the presence of bilaterally soft testes (P = 0.02) but not the presence of a varicocele. Testes in men with bilateral varicoceles were significantly smaller (P = 0.001) and softer (P = 0.001) than in men without varicoceles. Higher grade varicoceles were more likely to be associated with soft testes (P = 0.001) than were lower grade varicoceles.
  
  
  CONCLUSIONS
  The 42% prevalence of varicoceles in our elderly population was greater than that for historic control younger populations, suggesting either an increase with age or examiner sensitivity bias. Varicoceles in the elderly, especially when bilateral, significantly affect testicular consistency (softer) and testicular size (smaller), but do not directly decrease serum testosterone levels. The presence of bilaterally soft testes in elderly men indicates bilateral gonadal dysfunction and may be a physical examination finding associated with decreased serum testosterone.
authors.affiliation: Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Benjamin K
authors.initials: BK
authors.lastname: Canales
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Zapzalka
authors.forename: Cesar J
authors.initials: CJ
authors.lastname: Ercole
authors.forename: Patrick
authors.initials: P
authors.lastname: Carey
authors.forename: Erhard
authors.initials: E
authors.lastname: Haus
authors.forename: Dorothee
authors.initials: D
authors.lastname: Aeppli
authors.forename: Jon L
authors.initials: JL
authors.lastname: Pryor
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D014646:Varicocele / Q000150:complications / Q000453:epidemiology*