As many as 15 percent of men have varicoceles, masses of enlarged and dilated veins in the testicles. There is new evidence that varicoceles, long known to be a cause of male infertility, interfere with the production of testosterone – a crucial hormone to maintaining men’s health.
Results of new research by physician-scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center are in a recent edition of BJU International. They say microsurgery can increase testosterone levels in these men.
“Varicoceles are a much more serious problem than previously thought. Low testosterone causes significant health problems in men. Besides causing low energy, decreased muscle strength and sexual problems, it is a major risk factor for osteopenia/osteoporosis and can also cause changes in cognitive and psychological function, in particular, depression,” says Dr. Marc Goldstein, who initiated and led the study.
Varicoceles usually first appear during or shortly after puberty, explains Dr. Goldstein. “The common wisdom has been to leave them alone unless they are causing pain or infertility. But, 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.”
In the study, Dr. Goldstein and his 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 vs. 469 ng/dL) than the comparison group. After undergoing microsurgical varicocelectomy, testosterone levels significantly increased in 70 percent 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,” says Dr. Cigdem Tanrikut, one of the authors of the study.