Varicocele: the origin of benign prostatic hypertrophy? Testosterone dosages in the periprostatic plexus.
OBJECTIVE
In 2008, Gat et al. wrote the hypothesis that benign prostatic hypertrophy (BPH) was caused by reflux from high free testosterone containing blood from varicocele. The purpose of this study is to measure testosterone at the prostatic veins in patients operated for large BPH, confirming Gat's theory.


METHODS
In 13 patients, operated by Millin technique, the periprostatic plexus was punctured in 45° tilted position in order to the measure total and free testosterone and dihydrotestosterone. Brachial blood was taken simultaneously for similar measurements. Seven patients had a clinical varicocele.


RESULTS
High testosterone levels, in comparison with the brachial blood, were detected in only two patients. Dihydrotestosterone was at least doubled in all cases, demonstrating that the puncture was done in prostatic drainage area.


CONCLUSIONS
Gat's theory, concerning the role of varicocele in the origin of BPH, could not be confirmed in this study. Technical limitations can be responsible for this.
a Department of Urology , Ghent University Hospital , Belgium.
Karel
K
De Caestecker
a Department of Urology , Ghent University Hospital , Belgium.
Nicolaas
N
Lumen
a Department of Urology , Ghent University Hospital , Belgium.
Anne-Françoise
AF
Spinoit
a Department of Urology , Ghent University Hospital , Belgium.
Karel
K
Everaert
b Department of Clinical Pathology , Ghent University Hospital , Belgium.
Tom
T
Fiers
a Department of Urology , Ghent University Hospital , Belgium.
Willem
W
Oosterlinck
Benign prostatic hypertrophy; Dihydrotestosterone; Testosterone; Varicocele