Varicocelectomy Is Associated With Increases in Serum Testosterone Independent of Clinical Grade

Hsiao, Wayland; Rosoff, James S.; Pale, Joseph R.; Powell, Jonathan; Goldstein, Marc

doi:10.1016/j.urology.2013.01.060

Cited by 77 publications

(42 citation statements)

References 19 publications

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“…Varicoceles are not only common cause of male infertility (Gorelick & Goldstein, 1993;Jarow, 2001) but also cause Leydig dysfunction, resulting in male hypogonadism (And o et al,1984;Hsiao et al, 2011Hsiao et al, , 2013Luo et al, 2011;Sathya & Belur, 2011;Tanrikut et al, 2011;Dabaja et al, 2013). A microsurgical varicocelectomy can significantly increase the testosterone level (Hsiao et al, 2011(Hsiao et al, , 2013Sathya & Belur, 2011;Tanrikut et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…A microsurgical varicocelectomy can significantly increase the testosterone level (Hsiao et al, 2011(Hsiao et al, , 2013Sathya & Belur, 2011;Tanrikut et al, 2011). Comhaire & Vermeulen (1975) were the first to demonstrate the connection between varicocele and testosterone and found the decreased plasma testosterone concentration in varicocele patients.…”

Section: Introductionmentioning

confidence: 99%

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Significant alterations of serum hormone levels in the spermatic vein plexus of patients with varicoceles

et al. 2016

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The objective of this study was to evaluate the level of hormone variation between the peripheral blood and spermatic vein plexus in patients with varicoceles. A total of 23 patients diagnosed with varicoceles were enrolled in the study. All patients underwent a testicular artery-sparing microsurgical varicocelectomy. During the operation, a blood sample from the ipsilateral spermatic vein plexus and a peripheral blood sample were collected. A radioimmunoassay was performed to determine the total testosterone, free testosterone, dihydrotestosterone and oestradiol levels. An enzyme-linked immunosorbent assay was performed to determine the albumin level. The mean age of the patients was 32.3 ± 9.3 years. Compared with the hormone level in the peripheral blood, the total testosterone, free testosterone, dihydrotestosterone, and oestrogen levels were significantly increased in the left or right spermatic vein plexus (P < 0.05). There were no differences in the albumin levels in the peripheral blood and spermatic vein plexus (P > 0.05). The mean total testosterone, free testosterone, dihydrotestosterone, and oestradiol levels in the left spermatic vein plexus were 10.8-fold, 29.0-fold, 2.0-fold, and 26.6-fold those of the peripheral blood. The hormone concentration in the spermatic vein plexus was significantly higher than that in the peripheral blood in patients with varicoceles.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Significant alterations of serum hormone levels in the spermatic vein plexus of patients with varicoceles

et al. 2016

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“…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%

“…Hsiao et al retrospectively reviewed 78 men (82% for infertility) undergoing microsurgical subinguinal varicocele repair (40). All had TT <400 ng/dL.…”

Section: Varicocelectomy In Hypogonadal Menmentioning

confidence: 99%

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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“…Although several reports documented a significant increase in serum testosterone post-operatively (Tanrikut et al, 2011;Hsiao et al, 2013), others failed to echo such an improvement (Pierik et al, 2001;Rodriguez Pena et al, 2009). Similarly, no statistically significant influence on serum testosterone level was detected in this cohort.…”

Section: Discussionmentioning

confidence: 99%

Does the number of veins ligated during varicococele surgery influence post-operative semen and hormone results?

et al. 2016

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SUMMARYVaricocele is a well-established cause of male subfertility, which is directly proportional to its clinical grade. Although newer ultrasonic grading systems have taken into account the existence of pampiniform venous plexi, little is known about the clinical significance of the number of veins ligated during surgery. Very few undersized studies reported an influence which triggered the need to evaluate such association. This is a retrospective study of 378 patients who underwent left microsurgical subinguinal varicocoelectomy. Semen analyses and blood hormone studies performed pre-operatively were compared to those executed 6 months after surgery. Patients were divided into abnormal semen and normal semen groups based on their initial semen results. They were also subdivided according to the number of veins ligated intraoperatively into three groups: <5, 5-10, and >10 veins. Sperm count, total motility, and progressive motility were significantly increased in 62, 60.3, and 53.3% of patients post-operatively (p = 0.001), respectively. No significant differences in hormone levels were detected overall. Of the 378 patients, 332 had an abnormal semen analysis, while the remaining 46 patients had a normal result. Sperm count, total motility, and progressive motility significantly increased after varicocoelectomy in patients with an abnormal initial semen analysis (p = 0.001). In 48.7% of patients, 5-10 veins were ligated during surgery, whereas 28.3% had >10 and 23% had <5 ligated veins. No statistically significant differences were noted in the initial or the follow-up results among the number of vein subgroups. Varicocele ligation improves patients' fertility potential. This improvement, however, is not influenced by the number of veins ligated intraoperatively. Clinical grading maintains its superiority in the evaluation of varicocele patients.

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Varicocelectomy Is Associated With Increases in Serum Testosterone Independent of Clinical Grade

Cited by 77 publications

References 19 publications

Significant alterations of serum hormone levels in the spermatic vein plexus of patients with varicoceles

Significant alterations of serum hormone levels in the spermatic vein plexus of patients with varicoceles

Effects of varicocelectomy on serum testosterone

Does the number of veins ligated during varicococele surgery influence post-operative semen and hormone results?

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