title: Effects of varicocele on serum testosterone and changes of testosterone after varicocelectomy: a prospective controlled study.
abstract: OBJECTIVE
  To examine the hypotheses that clinical varicoceles affect baseline serum total testosterone levels (T) and varicocelectomy improves T.
  
  
  METHODS
  This prospective, nonrandomized, controlled study involved 4 groups of adult men. Varicocele-infertile treatment group (VIT) included 66 men who underwent varicocelectomy. Thirty-three varicocele-infertile control men (VIC) and 33 varicocele-fertile control men (VFC) were only observed. Normal-control (NC) group included 33 fertile men without varicocele. Varicocele groups were stratified into baseline hypogonadal (T <300 ng/dL) or eugonadal (T ≥300 ng/dL) subgroups. Main outcome measurements were between-group baseline T differences; and within-group T changes at 6- and 12-month follow-ups of men with varicocele. P <.05 was considered significant.
  
  
  RESULTS
  Means (standard deviations) of baseline T in VIT, VIC, VFC, and NC were 347.4 (132.1), 339.7 (125.8), 396.6 (164.9), and 504.8 (149.7) ng/dL, respectively. The baseline T levels of varicocele groups were comparable, whereas they were significantly low compared with NC group. At 6-month follow-up, VIT demonstrated significant T improvements (mean change = 44.7 ng/dL; 12.9%; P <.0001). T changes were more remarkable among baseline hypogonadals (mean change = 93.7 ng/dL; 40.1%; P <.0001) compared with eugonadals (mean change = 8.6 ng/dL; 2.01%; P = .1223). These improvements were persistent at 12-month follow-up. Contrariwise, VIC and VFC exhibited nonsignificant T changes. Postvaricocelectomy T changes correlated significantly and inversely with baseline T (r = -0.689; P <.0001). This correlation was stronger and more significant among hypogonadals (r = -0.528; P = .004) than eugonadals (r = -0.400; P = .013). T improvements also exhibited significant positive correlations with preoperative and postoperative sperm concentrations.
  
  
  CONCLUSIONS
  Baseline T was significantly low in men with varicocele compared with normal men. Varicocelectomy yielded significant T improvements among hypogonadal men but insignificant changes in eugonadals. T changes correlated strongly and significantly with baseline T and sperm concentrations.
authors.affiliation: Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Urology, El-Minia University, El-Minia, Egypt. Electronic address: tahaaboalmagd@yahoo.com.
authors.forename: Taha A
authors.initials: TA
authors.lastname: Abdel-Meguid
authors.affiliation: Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Farsi
authors.affiliation: Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al-Sayyad
authors.affiliation: Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Abdulmalik
authors.initials: A
authors.lastname: Tayib
authors.affiliation: Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Hisham A
authors.initials: HA
authors.lastname: Mosli
authors.affiliation: Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Abdulghafour H
authors.initials: AH
authors.lastname: Halawani
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D007248:Infertility, Male / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013076:Sperm Count; D013739:Testosterone / Q000097:blood*; D016896:Treatment Outcome; D013519:Urogenital Surgical Procedures; D014646:Varicocele / Q000150:complications* / Q000601:surgery*; D014656:Vascular Surgical Procedures; D055815:Young Adult
chemical_list: D013739:Testosterone