Tuesday, August 28, 2012

Varicocele Surgery Increases Testosterone Levels in Men


    from Medscape
  • The investigators conducted a search of the literature using the Medline/PUBMED database up to May 31, 2011. They also searched cross-references from eligible articles.
  • Included were studies describing patients who underwent varicocelectomy for unilateral or bilateral varicocele, with at least 2 testosterone evaluations (before and after the procedure) and follow-up of 1 month or longer.
  • The testosterone levels had to be measured using the same laboratory method, such as radioimmunoassay.
  • The primary outcome was the difference in testosterone level before and after the surgical procedure.
  • Studies could be randomized controlled trials, observational studies, and comparative studies.
  • 2 reviewers independently assessed the selected studies and tabulated extracted data to pool for the meta-analysis.
  • Of 125 potentially relevant studies, 9 were included for this analysis.
  • The 9 studies involved 814 patients who underwent varicocelectomy and follow-up for at least 3 months.
  • Each study had between 12 and 325 patients, with a mean age of 31.4 years.
  • Surgical procedures performed included inguinal or subinguinal varicocelectomy and sclerotherapy.
  • Diagnosis was by physical palpation of a varicocele before the procedure.
  • All men had serum testosterone levels measured before and after the procedure.
  • Mean serum testosterone levels were increased by a mean of 97.48 ng/dL (95% confidence interval, 43.73 - 151.22; P = .0004) from before to after the procedure.
  • The authors concluded that the procedure of varicocelectomy increases testosterone levels and may thus have benefits for male infertility.

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