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BJU Int. 2011 Nov;108(9):1480-4. doi: 10.1111/j.1464-410X.2010.10030.x. Epub 2011 Mar 24.

Varicocele as a risk factor for androgen deficiency and effect of repair.

Author information

1
Weill Cornell Medical College of Cornell University Massachusetts General Hospital, Boston, MA, USA. ctanrikut@partners.org

Abstract

OBJECTIVE:

• To determine whether men with varicoceles have lower testosterone levels than those without and to ascertain if testosterone levels increase after varicocelectomy.

PATIENTS AND METHODS:

• We measured preoperative testosterone levels in 325 men with palpable varicoceles and in 510 men with vasectomy reversal without varicoceles who served as a comparison group. • The testosterone levels between groups were compared by age. Of the men with varicoceles, 200 had data on both pre- and postoperative testosterone levels, which were compared to assess postoperative changes.

RESULTS:

• Men with varicocele had significantly lower testosterone levels than the comparison group, with mean (sd) levels of 416 (156) vs 469 (192) ng/dL (P < 0.001). This difference persisted when analysed by age. • The testosterone levels significantly increased after repair from 358 (126) to 454 (168) ng/dL (P < 0.001). • Of the 70% of patients with postoperative improvement in testosterone levels, the mean (sd) increase in testosterone was 178 (142) ng/dL. The percentage change in testosterone levels was: 30% had no increase, 41% increased by ≤ 50%, 19% increased between by 51-100%, and 10% increased by >100%. • There was no association between change in testosterone level and age, laterality of varicocele, or varicocele grade.

CONCLUSIONS:

• Men with varicoceles had significantly lower testosterone levels than the comparison group of men with vasectomy reversal. • Microsurgical varicocele ligation resulted in a significant increase in serum testosterone levels in more than two-thirds of men. • These findings suggest that varicocele is a significant risk factor for androgen deficiency and that repair may increase testosterone levels in men with varicocele and low testosterone levels.

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