Exploring the Association Between Varicocele and Testosterone Deficiency in Men Over 50 Years of Age

To define the impact of varicoceles (VX) on total testosterone (TT) levels in an aging male population.

This retrospective analysis of a departmental database assessed patients ≥50 years of age, who had 2 testes, and recorded early morning TT levels. Patient demographics, comorbidity profiles, VX laterality, and VX grade were also analyzed.

Data were retrievable for 776 patients. Mean age was 66±12years. Around 140 (18%) patients had at least 1 VX on examination (VX+). Of these 118 (84%) had unilateral VX while 22 (16%) had bilateral. Mean TT for the VX+ group (336ng/dL±168) was statistically significantly lower than for the VX- group (472ng/dL ±267) (P<.01). Those with bilateral VX had lower TT (297ng/dL) than those with unilateral VX (372ng/dL) (P<.05). While 16% of the total VX+ population had TT levels <300ng/dl, these rates were 11% and 24% in men with unilateral and bilateral VX (P<.01). In those with unilateral VX, there was a relationship between VX grade and testosterone deficiency, with the highest likelihood associated with Grade III (r=0.65, P<.01). There was no association between Grade I and low T levels.

In this population of men older than 50, the presence, laterality, and grade of VX were associated with lower levels of TT.