Differences in the clinical characteristics between young and elderly men with varicocoele

Abstract

Information concerning the clinical characteristics in elderly men with varicocoele is relatively limited. This study was assessed to evaluate the differences in clinical characteristics between young and elderly patients with varicocoele by retrospective chart review. Between June 2003 and February 2011, 169 young (18-30 years) men and 156 elderly (45-55 years) men with varicocoele, and 30 age-matched men without varicocoele were recruited for this study. All the patients were divided into six groups. Thirty-one infertile patients were assigned to Group 1, 138 fertile patients to Group 2, 35 infertile patients to Group 3 and 121 fertile patients to Group 4. Group 5 (15 young) and 6 (15 elderly) were control groups. The parameters for comparison included body mass index (BMI), semen quality (sperm motility, morphology and density) and pH value, serum concentration of follicle-stimulating hormone (FSH), luteinizing hormones (LH), testosterone, testicular volume, grade of varicocoele and peak retrograde flow (PRF) and maximal vein diameter (MVD) by colour Doppler ultrasound (CDS). Elderly men with varicocoele had a higher incidence of bilateral varicocoele (25.5% vs. 14.8%), but a lower incidence of unilateral right varicocoele (2.6% vs. 7.7%) than young patients with varicocoele. In addition, patients with varicocoele had lower BMI than those without, and infertile young patients with varicocoele had the lowest levels of BMI. Furthermore, infertile patients (Groups 1 and 3) with varicocoele had significantly lower testicular volume and semen pH, lower levels of testosterone, higher levels of FSH and LH and higher PRF than fertile men with varicocoele (Groups 2 and 4). In conclusion, infertile elderly patients with varicocoele had significantly lower levels of testosterone and higher levels of FSH and LH than infertile young men with varicocoele. In addition, infertile elderly patients with bilateral varicocoele (Group 3, n = 8) had the lowest levels of testosterone.

Scrotal abnormalities and infertility in west African men: A comparison of fertile and sub-fertile men using scrotal ultrasonography

“…Most studies have reported varicoceles to be more common on the left in both sub-fertile men and normal population [12][13][14][15]. Our findings were consistent with these.…”

“…About 47.6% of all varicoceles in infertile patients were bilateral. The reported prevalence of scrotal US diagnosed bilateral varicoceles in sub-fertile men, however varies widely, accounting for 11-40% of cases of varicoceles with the incidence said to be higher in the older men [12]. Reasons for the relatively high bilateral prevalence in sub-fertile men in this study are unclear.…”

“…Reports in literature have also described varicocele as the most common identifiable abnormality detected in infertile men on scrotal US. While varicocele has traditionally been reported to have an overall prevalence of 29-40% in all infertile men [3,5,6,[11][12][13], more recently some authors have reported prevalence of 35-41% in men with primary infertility and 70-81% in men with secondary infertility [11,14]. Even though 75.2% of the sub-fertile subjects in this study gave a history of having impregnated previous partners in the past, differentiation of primary and secondary infertility in our environment is usually not a straightforward matter as the usual story is that of the man claiming to have given his previous partner(s) money to terminate unwanted pregnancy(ies) without any effort to confirm the (female) partner's claims.…”

Significant predictive factors for subfertility in patients with subclinical varicocele

“…In the present study, there is no significant difference in semen quality between the young and the elderly (>50 years) subfertile patients with SV. Patients with SV also have lower chances of subfertility than patients with varicocele, regardless of age (Chen, ). Nonetheless, the aetiology warrants further evaluation.…”

“…() suggested that weight and body mass index (BMI) both had protective roles on the development of varicocele in boys. A previous study showed that patients with varicocele had lower BMI than healthy, age‐matched controls (Chen, ). Cervellione, Corroppolo, and Bianchi () also reported that 28% children with SV would progress to varicocele in a four‐year follow‐up.…”