A preliminary evaluation of serum level of testosterone, LH, and FSH in patients with varicocele after varicocelectomy as a kidney-related disease

Abstract

IntroductionVaricocele is a common problem with a high prevalence in population with primary and secondary infertilities. The adverse effects of varicocele on spermatogenesis and fertility are known, but the association between clinical varicocele and testosterone is not clear. Hence, we decided to evaluate the serum levels of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in patients with varicocele after varicocelectomy.MethodsIn this study, 100 patients with varicocele were divided into two groups: hypogonadal patients with testosterone level <280 ng/dL and eugonadal patients with testosterone level >280 ng/dL. The serum levels of testosterone, FSH, and LH were measured before surgery and 3 months after surgery, and the results were analyzed using the SPSS software. P-value <0.05 was considered statistically significant.ResultsPatients with varicocele after puberty till 50 years were divided into two groups: hypogonadal (testosterone <280 ng/dL) and eugonadal (testosterone >280 ng/dL) patients who required varicocelectomy. The mean testosterone level before surgery in hypogonadal patients was 215.22±83.31 ng/dL, which reached 326.95±35.125 ng/dL after surgery (P<0.0001), which was significant. There was no significant decrease in the mean FSH level, but there was a significant decrease in the mean LH level after varicocelectomy. In eugonadal group, testosterone level before surgery was 471.90±145.71 ng/dL, which reached 469.57±145.61 ng/dL after surgery, which was not significant.ConclusionIn our study, patients who underwent varicocelectomy had improved testosterone levels, so that this increase was more significant in hypogonadal patients than in eugonadal patients. Decrease in LH and FSH levels in all patients was seen after varicocelectomy, which can be due to increase in testosterone levels.

Varicocele: An Endocrinological Perspective

“…On the other hand, just 8% of the people exhibited high basal LH levels; however, in the severely oligozoospermic patients ( n = 11), LH was significantly higher ( Z = 2.190; p < 0.05) than in normozoospermic men ( 35 ). Moreover, a statistically significant difference between pre- and post-varicocelectomy LH concentration was found in hypogonadal patients more than in eugonadal ones, whereas no significant difference in FSH concentrations was found ( 33 ). In a case-control study, Garolla et al evaluated 40 patients with left varicocele, 20 obese men and 20 healthy control subjects for a series of parameters such as testicular volume, hormones, sperm parameter and 24-h scrotal temperature monitoring by a cutaneous thermochip.…”

“…Different studies demonstrated the relationship between varicocele repair and testosterone levels, suggesting that varicocelectomy leads to an enhancement of testosterone production up to eugonadal levels, significant for men of all age groups ( 31 , 32 ). A recent study including 100 patients (50 hypogonadal and 50 eugonadal) with varicocele of all grades, showed a significant difference in pre- and post-varicocelectomy testosterone concentrations in hypogonadal patients but not in eugonadal ones ( 33 ).…”

Melatonin epigenetic potential on testicular functions and fertility profile in varicocele rat model is mediated by silent information regulator 1

“…The increased internal scrotal temperature may trigger marked reduction in Sertoli cell function and testosterone synthesis by Leydig cells, together with germinal cells damage (Antonuccio, Micali, et al, 2021). Other evidence indicates that the increased hydrostatic pressure in the testicular venous system above that of the arterial pressure as a cause of testicular hypoxia and abnormal arterial flow (Alizadeh et al, 2018).…”

Gui-A-Gra Attenuates Testicular Dysfunction in Varicocele-Induced Rats via Oxidative Stress, ER Stress and Mitochondrial Apoptosis Pathway

“…Spermatogenesis is regulated by the hypothalamic-pituitary-testicular axis system [31]. Upregulation of serum LH and FSH levels might be due to a feedback mechanism of the hypothalamus-pituitary-testicular axis [32]. Pretreatment with Gui-A-Gra increased StAR protein expression and serum testosterone level but downregulated serum LH and FSH levels, suggesting androgenic properties of Gui-A-Gra.…”