Effects of varicocelectomy on serum testosterone

Area of Science:

• Andrology
• Urology
• Endocrinology

Background:

• Varicocele, a common cause of male infertility, is increasingly associated with low serum testosterone.
• Surgical repair of varicocele is a standard treatment for infertility, but its impact on testosterone levels is under investigation.

Approach:

• A systematic literature review was conducted, analyzing 28 human studies on varicocele repair and serum testosterone.
• Studies were evaluated based on preoperative testosterone levels, surgical technique, and the presence of control groups.

Key Points:

• Fifteen of the 28 reviewed studies indicated improved serum testosterone levels after varicocele repair.
• Improvements were most pronounced in men with initially low or below-normal testosterone levels.
• Well-designed studies with control groups showed significant differences in testosterone levels post-repair.

Conclusions:

• Microsurgical varicocele repair shows potential for improving serum testosterone in men with preoperative hypogonadism.
• The efficacy in men presenting without infertility requires further investigation.
• Identifying patients at risk for testosterone deficiency due to varicocele and the potential preventative role of repair remain areas for future research.