title: Varicocele as a risk factor for androgen deficiency and effect of repair.
abstract: OBJECTIVE
  • To determine whether men with varicoceles have lower testosterone levels than those without and to ascertain if testosterone levels increase after varicocelectomy.
  
  
  METHODS
  • We measured preoperative testosterone levels in 325 men with palpable varicoceles and in 510 men with vasectomy reversal without varicoceles who served as a comparison group. • The testosterone levels between groups were compared by age. Of the men with varicoceles, 200 had data on both pre- and postoperative testosterone levels, which were compared to assess postoperative changes.
  
  
  RESULTS
  • Men with varicocele had significantly lower testosterone levels than the comparison group, with mean (sd) levels of 416 (156) vs 469 (192) ng/dL (P < 0.001). This difference persisted when analysed by age. • The testosterone levels significantly increased after repair from 358 (126) to 454 (168) ng/dL (P < 0.001). • Of the 70% of patients with postoperative improvement in testosterone levels, the mean (sd) increase in testosterone was 178 (142) ng/dL. The percentage change in testosterone levels was: 30% had no increase, 41% increased by ≤ 50%, 19% increased between by 51-100%, and 10% increased by >100%. • There was no association between change in testosterone level and age, laterality of varicocele, or varicocele grade.
  
  
  CONCLUSIONS
  • Men with varicoceles had significantly lower testosterone levels than the comparison group of men with vasectomy reversal. • Microsurgical varicocele ligation resulted in a significant increase in serum testosterone levels in more than two-thirds of men. • These findings suggest that varicocele is a significant risk factor for androgen deficiency and that repair may increase testosterone levels in men with varicocele and low testosterone levels.
authors: Weill Cornell Medical College of Cornell University Massachusetts General Hospital, Boston, MA, USA. ctanrikut@partners.org
authors: Cigdem
authors: C
authors: Tanrikut
authors: Marc
authors: M
authors: Goldstein
authors: James S
authors: JS
authors: Rosoff
authors: Richard K
authors: RK
authors: Lee
authors: Christian J
authors: CJ
authors: Nelson
authors: John P
authors: JP
authors: Mulhall
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008866:Microsurgery; D012307:Risk Factors; D013739:Testosterone / Q000097:blood* / Q000172:deficiency*; D016896:Treatment Outcome; D014646:Varicocele / Q000097:blood* / Q000601:surgery
chemical_list: D013739:Testosterone