The relationship between varicoceles and obesity

To determine if a relationship between weight and varicocele occurrence exists, the prevalence of varicoceles was determined in a population of patients presenting with infertility.

Records of 3,213 males presenting with infertility were examined. Patients underwent physical examinations for varicocele presence and grade. Body mass index was calculated. Patients were categorized as normal weight, overweight and obese using National Institutes of Health criteria. Means were compared with Student's t test. Frequencies were compared by chi-square analysis and statistical significance was considered at p < 0.05.

A total of 1,093 (34%) patients had varicoceles. The mean body mass index of those without varicoceles was 28.5 (+/- 5.6) kg/cm2, which was greater than the body mass index of those with varicoceles (26.7 [+/- 4.0] kg/cm2) (p < 0.001). Varicocele frequency was calculated for each body mass index group. In the normal weight group (body mass index less than 25) 378 of 884 patients (43%) had varicoceles. In the overweight group (body mass index 25 to less than 30) 540 of 1,549 patients (35%) had varicoceles. In the obese group (body mass index 30 or greater) 175 of 780 patients (22%) had varicoceles (p < 0.001). Analysis comparing varicocele frequency based on varicocele grade per body mass index group was performed. Prevalence of varicocele decreased with increasing body mass index for all varicocele grades (p < 0.001).

Prevalence of varicocele decreases with increasing body mass index. One explanation is increased adipose tissue preventing compression of the left renal vein. Another explanation is decreased detection due to adipose tissue in the spermatic cord. The decrease in varicocele prevalence as a function of body mass index regardless of varicocele grade suggests this explanation is less likely.