Weill Cornell Medical College of Cornell University Massachusetts General Hospital, Boston, MA, USA.
BJU Int. 2011 Nov;108(9):1480-4. doi: 10.1111/j.1464-410X.2010.10030.x. Epub 2011 Mar 24.
• To determine whether men with varicoceles have lower testosterone levels than those without and to ascertain if testosterone levels increase after varicocelectomy.
• We measured preoperative testosterone levels in 325 men with palpable varicoceles and in 510 men with vasectomy reversal without varicoceles who served as a comparison group. • The testosterone levels between groups were compared by age. Of the men with varicoceles, 200 had data on both pre- and postoperative testosterone levels, which were compared to assess postoperative changes.
• Men with varicocele had significantly lower testosterone levels than the comparison group, with mean (sd) levels of 416 (156) vs 469 (192) ng/dL (P < 0.001). This difference persisted when analysed by age. • The testosterone levels significantly increased after repair from 358 (126) to 454 (168) ng/dL (P < 0.001). • Of the 70% of patients with postoperative improvement in testosterone levels, the mean (sd) increase in testosterone was 178 (142) ng/dL. The percentage change in testosterone levels was: 30% had no increase, 41% increased by ≤ 50%, 19% increased between by 51-100%, and 10% increased by >100%. • There was no association between change in testosterone level and age, laterality of varicocele, or varicocele grade.
• Men with varicoceles had significantly lower testosterone levels than the comparison group of men with vasectomy reversal. • Microsurgical varicocele ligation resulted in a significant increase in serum testosterone levels in more than two-thirds of men. • These findings suggest that varicocele is a significant risk factor for androgen deficiency and that repair may increase testosterone levels in men with varicocele and low testosterone levels.
我们测量了 325 名可触及精索静脉曲张男性和 510 名精索静脉曲张逆转男性（作为对照组）的术前睾酮水平。
通过年龄比较两组的睾酮水平。在精索静脉曲张患者中，有 200 人有术前和术后的睾酮水平数据，以评估术后变化。
精索静脉曲张患者的睾酮水平明显低于对照组，平均（标准差）水平分别为 416（156）与 469（192）ng/dL（P < 0.001）。这种差异在按年龄分析时仍然存在。
修复后，睾酮水平显著升高，从 358（126）升至 454（168）ng/dL（P < 0.001）。
在术后睾酮水平改善的 70%患者中，睾酮平均（标准差）增加 178（142）ng/dL。睾酮水平的百分比变化为：30%无增加，41%增加≤50%，19%增加 51-100%，10%增加>100%。
睾酮水平变化与年龄、精索静脉曲张的侧别或精索静脉曲张的分级之间无关联。
患有精索静脉曲张的男性的睾酮水平明显低于精索静脉曲张逆转的对照组男性。
显微镜下精索静脉曲张结扎术导致超过三分之二的男性血清睾酮水平显著升高。
这些发现表明精索静脉曲张是雄激素缺乏的一个重要危险因素，修复可能会增加患有精索静脉曲张和低睾酮水平的男性的睾酮水平。
