title: Improvements in Patient-reported Sexual Function After Microsurgical Varicocelectomy.
abstract: To evaluate whether varicocelectomy improves both serum testosterone and sexual function, as assessed by the Male Sexual Health Questionnaire (MSHQ).
  
  
  
  A retrospective chart review of patients who have undergone varicocelectomy and had both pre- and postoperative MSHQ was performed. The MSHQ is a clinically validated questionnaire that assesses erectile function, ejaculatory function, and sexual satisfaction, with higher scores indicating better function. Clinical parameters pre and postvaricocelectomy were compared with paired t test.
  
  
  
  Thirty-four patients met study criteria. Seventeen patients (50%) presented for infertility, and the remaining 13 had symptomatic varicocele associated with hypogonadism. Average postsurgical follow-up was 20.6 ± 12.5 months. The majority of men in the study had bilateral varicoceles and left grade III varicoceles. Significant improvements in the total MSHQ score (3.9 ± 8.7, P = .027), the MSHQ erectile function (1.2 ± 2.3, P = .007), and the MSHQ ejaculatory function (1.4 ± 3.1, P = .018) domains were seen. Fifteen (44%) men saw improvement in their erectile function and 18 (53%) saw improvement in ejaculatory function. The improvement in serum testosterone was also significant (136.0 ± 201.3 ng/dL, P = .007).
  
  
  
  Microsurgical repair of varicocele not only improves testosterone, but also improves patient-reported erectile and ejaculatory functions. Patients can confidently be counseled that varicocelectomy has the potential to improve sexual function along with serum testosterone.
authors.affiliation: Departments of Urology and Population Health, New York University School of Medicine, New York, NY.
authors.forename: Bobby B
authors.initials: BB
authors.lastname: Najari
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, NY.
authors.forename: Leonard
authors.initials: L
authors.lastname: Introna
authors.affiliation: Department of Urology, Weill Cornell Medical College, New York, NY; Department of Reproductive Medicine, Weill Cornell Medical College, New York, NY. Electronic address: dap2013@med.cornell.edu.
authors.forename: Darius A
authors.initials: DA
authors.lastname: Paduch
mesh_terms: D000328:Adult; D004542:Ejaculation; D006801:Humans; D008297:Male; D008866:Microsurgery; D009948:Orgasm; D000071066:Patient Reported Outcome Measures; D010410:Penile Erection; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014646:Varicocele / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods
chemical_list: D013739:Testosterone