Improvement of Sexual Activity, Pregnancy Rate, and Low Plasma Testosterone After Bilateral Varicocelectomy in Impotence and Male Infertility Patients

Younes, Abdel

doi:10.1080/713828127

Cited by 6 publications

(9 citation statements)

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“…Hypo‐active sexual desire, pre‐mature ejaculation and overall frequency of ED were shown in 144/200 (72%) and 31/200 (15.5%), 76/141 (53.9%) of hypogonadal men, respectively (Sathya Srini & Belur Veerachari, ), as this can be attributed to low T, associated with varicocele. Another study reported an improvement of sexual activity of 50%–75% after varicocelectomy in impotent males (Younes, ). However, these studies were retrospective or nonrandomised controlled studies based on limited number of samples.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: A meta-analysis

et al. 2017

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To reassess the efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males, we carried out a meta-analysis of clinical trials and retrospective studies that compared the pre-operative and postoperative serum testosterone. We searched Embase and PubMed (1980 to May 2016) for studies. Eight studies and 712 patients were included. The combined analysis of seven studies discovered that the mean serum testosterone of patients post-operation improved by 34.3 ng/dl (95% CI: 22.57-46.04, p < .00001, I² = 0.0%) compared with their pre-operative levels. In subgroup analysis, testosterone improvements in the hypogonadal treated subgroup were more significant (improved by 123 ng/dl, 95% CI: 114.61-131.35, p < .00001, I = 37%) than in the eugonadals, or the untreated controls. In an analysis of surgery versus untreated control (three studies included), results showed that mean testosterone among hypogonadals increased by 105.65 ng/dl (95% CI: 77.99-133.32), favouring varicocelectomy, as the differences were significant (p < .00001), However, there were insignificant differences in eugonadals (p = .36). In conclusion, varicocelectomy significantly improved testosterone in hypogonadal men with subfertility. Active surgical treatment of varicocele might have a benefit of maintaining healthy androgen levels in subfertile men.

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Section: Discussionmentioning

confidence: 99%

Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: A meta-analysis

et al. 2017

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“…(), who prospectively evaluated the effect of microsurgical varicocelectomy on gonadal and erectile functions in men with hypogonadism and infertility and found that varicocelectomy significantly improves serum testosterone and IIEF‐5 in infertile men. Younes () also reported improvement of sexual activity by 50–75%, the pregnancy rate by 37% and increased plasma testosterone levels over a period of 3 years of follow‐up after varicocele repair.…”

Section: Discussionmentioning

confidence: 93%

“…Although we observed many patients suffering PE among patients with varicocele and previous studies reported the association of varicocele and PE, we were unable to do varicocelectomy for PE as a main indication. In our countries, it is unethical to do an invasive procedure to the patients with uncertain outcome because, to our knowledge, few authors have reported an association between varicocelectomy and improvement of PE in a limited series of subjects (Younes, ). So that we conducted this prospective study in PE patients having varicocele and would undergo varicocelectomy for other indications and compared them with untreated patients as control to evaluate the effect of varicocelectomy on PE.…”

Section: Discussionmentioning

confidence: 99%

Impact of varicocelectomy on premature ejaculation in varicocele patients

et al. 2014

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In a prospective manner, we studied the effect of varicocelectomy on premature ejaculation and testicular hormonal function in patients with varicocele. Microsurgical subinguinal varicocelectomy was carried out in 73 patients with clinical varicocele associated with premature ejaculation (group 1) and compared with 56 patients without operative intervention (group 2; control). The primary efficacy variable was the mean change in the Premature Ejaculation Diagnostic Tool. The changes in International Index of Erectile Function questionnaire, total serum testosterone and testicular size were also assessed. In group 1, the Premature Ejaculation Diagnostic Tool decreased significantly after varicocelectomy, from 15.56 to 11.37 (P < 0.001), indicating improvement of premature ejaculation. Thirty patients (41.1%) showed improvement of premature ejaculation compared to 5.3% in the control group (P < 0.001). In group I, but not in group II, testosterone levels and International Index of Erectile Function values increased significantly when compared with pre-operative values (P< 0.001 and 0.040 respectively). Testicular size increased after varicocelectomy, but this increase was nonsignificant till the end of study (P = 0.054). We concluded that varicocelectomy is clearly related to improvement of premature ejaculation and testicular hormonal function in varicocele patients.

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“…Repair of a varicocele can prevent further testicular damage, improve sperm production, and improve testosterone production [72]. Ligation of a varicocele may help prevent infertility and low testosterone levels after repair [77,78]. Several investigators have sought to determine preoperative characteristics of a varicocele that would predict response to varicocelectomy [79,80].…”

Section: Testicular Dysfunction Varicocelesmentioning

confidence: 99%

Gastrointestinal Endoscopy and Pathologic Findings

2011

Clinical Management of Intestinal Failure

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Medical treatment for male infertility generally falls under two categories: specific therapy and empiric therapy. In approaching a patient, it is practical to first seek a clear etiology to which a specific strategy can be applied rather than using medication for all infertile patients. When a cause cannot be identified, several hormonal therapies are available. It is difficult to predict who will respond to empiric hormonal treatment of idiopathic infertility, but this choice may prove valuable in conjunction with advanced assisted reproductive techniques. Specific therapy GonadotropinsHypogonadotropic hypogonadism accounts for less than 1% of all cases of male infertility and is discussed in great detail by Layman elsewhere in this issue. Gonadotropin replacement is the rational treatment and is the only clearly accepted and effective management of associated infertility. Normal male fertility requires adequate levels of intratesticular testosterone and follicle-stimulating hormone (FSH); the latter has been shown to initiate and maintain spermatogenesis [1,2]. FSH administered to men who have hypogonadotropic hypogonadism has demonstrated increases in sperm count, motility, morphology, and testicular volume [3]. Thus, it has been postulated that treatment solely with FSH may be adequate, however prolonged.

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Improvement of Sexual Activity, Pregnancy Rate, and Low Plasma Testosterone After Bilateral Varicocelectomy in Impotence and Male Infertility Patients

Cited by 6 publications

References 0 publications

Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: A meta-analysis

Efficacy of varicocelectomy in the treatment of hypogonadism in subfertile males with clinical varicocele: A meta-analysis

Impact of varicocelectomy on premature ejaculation in varicocele patients

Gastrointestinal Endoscopy and Pathologic Findings

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