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.

MATERIALS AND 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.

CONCLUSION:

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: Taha A Abdel-Meguid, Hasan M Farsi, Ahmad Al-Sayyad, Abdulmalik Tayib, Hisham A Mosli, Abdulghafour H Halawani
• Journal: Urology (Urology) Vol. 84 Issue 5 Pg. 1081-7 (Nov 2014) ISSN: 1527-9995 [Electronic] United States
• PMID: 25214202 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Testosterone

Topics

• Adult
• Case-Control Studies
• Humans
• Infertility, Male (surgery)
• Male
• Middle Aged
• Prospective Studies
• Sperm Count
• Testosterone (blood)
• Treatment Outcome
• Urogenital Surgical Procedures
• Varicocele (complications, surgery)
• Vascular Surgical Procedures
• Young Adult