title: Chronic constipation: facilitator factor for development of varicocele.
abstract: OBJECTIVE
  To evaluate the possible relationship between varicocele and chronic constipation.
  
  
  METHODS
  Between April 2009 and May 2010, a total of 135 patients with varicocele or constipation and 120 healthy controls were evaluated. Patients were divided into two groups. In both groups detailed medical history was taken and all patients were examined physically by the same urologist and gastroenterologist. All of them were evaluated by color Doppler ultrasonography. All patients with constipation, except for the healthy controls of the second group, underwent a colonoscopy to identify the etiology of the constipation. In the first group, we determined the rate of chronic constipation in patients with varicocele and in the second group, the rate of varicocele in patients with chronic constipation. In both groups, the rate of the disease was compared with age-matched healthy controls. In the second group, the results of colonoscopies in the patients with chronic constipations were also evaluated.
  
  
  RESULTS
  In the first group, mean age of the study and control groups were 22.9 ± 4.47 and 21.8 ± 7.21 years, respectively (P < 0.05). In the second group, mean age of the study and control groups were 52.8 ± 33.3 and 51.7 ± 54.3 years, respectively (P < 0.05). In the first group, chronic constipation was observed in 8 of the 69 patients with varicocele (11.6%) and 3 out of 60 in healthy controls (5%), respectively. In this regard, there was no statistical significance between varicocele patients and the healthy control (P = 0.37). In the second group, varicocele was observed in 16 of the 66 patients with chronic constipation (24.24%) and 12 out of 60 in healthy controls (20%) respectively. Similarly, there was no statistical significance between chronic constipation and healthy controls (P = 0.72). Internal/external hemorrhoids were detected in 4 of the 16 patients with chronic constipation and varicocele, in the second group. In the remaining 50 patients with chronic constipation 9 had internal/external hemorrhoids. In this regard, there was no statistical significance between chronic constipation and healthy controls (P = 0.80).
  
  
  CONCLUSIONS
  Chronic constipation may not be a major predictive factor for the development of varicocele, but it may be a facilitator factor for varicocele.
authors.affiliation: Department of Gastroenterology, Gulhane Military Medical Academy, Ankara, 06100, Turkey.
authors.forename: Guldem
authors.initials: G
authors.lastname: Kilciler
authors.forename: Ahmet Ali
authors.initials: AA
authors.lastname: Sancaktutar
authors.forename: Ali
authors.initials: A
authors.lastname: Avcı
authors.forename: Mete
authors.initials: M
authors.lastname: Kilciler
authors.forename: Engin
authors.initials: E
authors.lastname: Kaya
authors.forename: Murat
authors.initials: M
authors.lastname: Dayanc
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003248:Constipation / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D014646:Varicocele / Q000000981:diagnostic imaging / Q000209:etiology*; D055815:Young Adult