Badereddin Mohamad Al-Ali1*, Emma Persad2 and Klaus Eredics3
1Department of Urology, Hanusch Hospital, Austria
2Karl Landsteiner University for Health Sciences, Austria
3Department of Urology, Donauspital Vienna, Austria
Introduction: The aim of our study was to analyze the impact of varicocele and varicocele surgery on testosterone level, semen quality, and erectile function.
Methods: Our study included 265 infertile males with varicocele. Patients were divided into three groups: Group 1 (193) patients who did not receive surgery, Group 2 (72 patients) who were operated on according to the Palomo procedure and Group 3 (28 patients), who acted as a control group without a varicocele. All patients completed the International Index of Erectile Function IIEF-5 (German version) and underwent semen analysis. Serum testosterone, Follicle Stimulating Hormone (FSH), and Luteinizing Hormone (LH) were measured at inclusion into the study and after surgery.
Results: The IIEF-5 scores in groups 1 and 2 were 21.01 ± 2.2; and 21.74 ± 1 respectively, and the resulting t-test for equality of variance was significant (p<0.0001). Total testosterone level in groups 1 and 2 were 3.16 ± 0.37, and 3 ± 0.01 respectively, and the resulting t-test for equality of variance was significant (p<0.0001). The results of the semen analysis were better in group 2 (after surgery) (37.5%, p<0.001) in comparison to Group 1. Interestingly, pre-operative serum testosterone levels were lower in patients with later improvement of semen analysis (p=0.05). Body mass index (p=0.8), pre-operative serum FSH (p=0.9), LH (p=0.2), were similar in both groups.
Conclusion: Semen quality improved in 37.5% of our patients after varicocele surgery. Erectile dysfunction improved partly after varicocele surgery. Moreover, these improvements are not necessarily correlated. Our study reported that a lower pre-operative serum testosterone level might be a possible indicator for successful surgical outcome.
Erectile Dysfunction; International Index of Erectile Function; Follicle stimulating hormone; Luteinizing hormone; Oligo-astheno-teratospermia-syndrome
Al-Ali BM, Persad E, Eredics K. Impact of Varicocele and Varicocele Surgery on Semen Quality, Erectile Function, and Serum Hormone Levels. Clin Surg. 2021; 6: 3219..