Varicoceles may interfere with the production of testosterone in men, but microsurgery can increase testosterone levels in these patients, according to researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center and Memorial Sloan-Kettering Cancer Center, New York.
"Varicoceles are a much more serious problem than previously thought," said co-author Marc Goldstein, MD, of New York-Presbyterian Hospital/Weill Cornell Medical Center. "As a result of our study, I recommend that teenagers and men with serious varicoceles be referred to a male reproductive urologist experienced in microsurgical varicocelectomy. It is much easier to prevent future fertility problems and low testosterone than wait until the damage has already occurred."
Adult men with a varicocele and low testosterone should also consider microsurgery sooner rather than later, he said.
For the study, which was published online in BJU International (March 24, 2011), Dr. Goldstein and colleagues measured the preoperative testosterone levels of 325 men with varicoceles and in 510 men without varicoceles. They found that men at every age with varicoceles had significantly lower testosterone levels (416 ng/dL vs. 469 ng/dL) than the comparison group. After undergoing microsurgical varicocelectomy, testosterone levels significantly increased in 70% of the patients, with a mean increase of 178 ng/dL.
"This research indicates that varicocele surgery, at the least, prevents further deterioration of testosterone production," said co-author Cigdem Tanrikut, MD, of Harvard Medical School, Boston, and Weill Cornell Medical College.