Effects of Varicocele on Serum Testosterone and Changes of Testosterone After Varicocelectomy: A Prospective Controlled Study

Hamoda, Taha Abo-Almagd Abdel-Meguid; Farsi, Hasan M.; Al-Sayyad, Ahmad; Tayib, Abdulmalik M.; Mosli, Hisham A.; Halawani, Abdulghafour

doi:10.1016/j.urology.2014.05.029

Cited by 67 publications

(44 citation statements)

References 22 publications

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“…Interestingly, Zhody et al (38) and Srini et al (39) also noted that men who did not undergo repair had decreased TT. Abdel-Meguid et al (41) did not observe these same results. All populations were small, but the data may suggest that not repairing varicocele in men results in developing or worsening hypogonadism.…”

Section: Varicocelectomy In Hypogonadal Menmentioning

confidence: 81%

“…It would therefore be reasonable to conclude that not all men would necessarily become hypogonadal as a result of a varicocele. It should also be noted that in subgroup analysis, two of the studies did demonstrate a decrease in TT in men who elected not to undergo surgical repair (40,41). It could be hypothesized that men with varicocele are at greater risk for hypogonadism.…”

Section: Discussionmentioning

confidence: 96%

“…This was most prominently observed in hypogonadal men or men with low-normal TT. Of the fifteen studies with increased TT, twelve (22,26,27,30,38-43,49,50) were with average initial TT <400 ng/dL with six of seven prospective studies in hypogonadal or low-normal TT levels (27,38,39,41,42,49). When weighted according to patient population, the average starting TT for those with increased TT was 326 ng/dL while the average TT for those without increased TT was 535 ng/dL.…”

Section: Discussionmentioning

confidence: 99%

“…Varicocele in the setting of low testosterone has been most extensively studied recently, with four studies of infertile men or subcohorts of men with low or low normal TT (38-41). Data is shown in Table 2 .…”

Section: Varicocelectomy In Hypogonadal Menmentioning

confidence: 99%

“…Abdel-Meguid et al recently prospectively analyzed 171 men with varicocele, infertility and abnormality on SA (41). Sixty-six infertile men with varicocele chose to undergo microsurgical subinguinal varicocele repair, 33 infertile men with varicocele chose assisted reproductive techniques, 33 fertile men (fertility definition not mentioned) with varicocele chose conservative management and 33 age-matched fertile men without varicocele were used as a control group.…”

Section: Varicocelectomy In Hypogonadal Menmentioning

confidence: 99%

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Effects of varicocelectomy on serum testosterone

Whelan

Levine

2016

Transl. Androl. Urol.

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Varicocele is most often surgically repaired due to male infertility, however, has recently been linked to low serum testosterone. This paper serves to review the current literature regarding varicocele and its subsequent repair on serum testosterone. Twenty-eight human studies were identified with fifteen showing improved serum testosterone after repair. The majority of the studies that demonstrated improvement had preoperative testosterone levels that were low or below normal. Additionally, multiple well-designed studies with control groups not undergoing surgical repair demonstrated significant difference between groups. This improvement was less observed in studies with normal preoperative serum testosterone. A majority of these patients studied were presenting for infertility. It remains to be determined if these findings can be reproduced in men without infertility. The findings suggest that microsurgical varicocele repair can improve serum testosterone in men with low levels preoperatively in appropriately counseled men. It remains to be seen whether varicocele repair can help prevent the development of low testosterone in the future or which patients are at risk of developing low testosterone due to varicocele.

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Section: Varicocelectomy In Hypogonadal Menmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Varicocelectomy In Hypogonadal Menmentioning

confidence: 99%

Section: Varicocelectomy In Hypogonadal Menmentioning

confidence: 99%

See 3 more Smart Citations

Effects of varicocelectomy on serum testosterone

Whelan

Levine

2016

Transl. Androl. Urol.

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Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels

et al. 2020

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Objective The goal of this work was to evaluate if men who underwent microsurgical varicocelectomy would have improvement in serum testosterone (T) as well as serum 17-hydroxyprogesterone (17-OHP—An intratesticular T biomarker) in addition to semen parameters after operation. Materials and Methods We conducted a prospective analysis of 30 men who underwent microsurgical varicocelectomy from December 2018 to September 2019. We assessed varicocele grade and laterality, serum T, serum 17-OHP, serum follicle- stimulating hormone (FSH), serum LH, and semen parameters in baseline and follow-up. According to the data distribution, we reported the median and interquartile ranges and utilized the Mann-Whitney U, Student’s t test and Wilcoxon rank test. Correlation analysis was performed with the Spearman test. Results In the baseline, 9 (30%) men had 17-OHP < 55 ng/dL and 21 (70%) men presented with 17-OHP > 55 ng/dL. Also, 19 men had TMSC < 9 million, including 6 men with azoospermia, 1 man with cryptozoospermia, and 11 men with TMSC > 9 million. We found an improvement in most SA parameters of most men, which include concentration (63.3%, 19/30), motility (46.6%, 14/30), and TMSC (60%, 18/30). About seven (36.8%) men had TMSC upgraded to > 9. There was a significant change in volume (2.1 [1.5–2.8] to 2.4 [1.7–3.6] cc, P = .018), concentration (6.8 [0.8–22.5] to 12.5 [1–31] million/cc, P = .047) and TMSC (4.4 [0.3–15.1] to 10.5 [0–41.8] million, P = .012) after surgery. We neither found a change in serum T nor a change in intratesticular T (serum 17-OHP) after varicocelectomy ( P > .05). FSH, LH and T were similar both before and after varicocelectomy ( P > .05). Conclusion Despite improvement in semen parameters following varicocelectomy, we did not see changes in either serum or intratesticular T. This suggests that improvement of semen parameters following varicocele repair could be from factors other than changes in androgen levels within the testis.

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Causes of Male Infertility

Machen

Sandlow

2020

Male Infertility

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Effects of Varicocele on Serum Testosterone and Changes of Testosterone After Varicocelectomy: A Prospective Controlled Study

Cited by 67 publications

References 22 publications

Effects of varicocelectomy on serum testosterone

Effects of varicocelectomy on serum testosterone

Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels

Causes of Male Infertility

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