Impact of Varicocele and Varicocele Surgery on Semen Quality, Erectile Function and Serum Hormone Levels

2018 ◽  
Vol 1 (1) ◽  
pp. 129-136
Author(s):  
Badereddin Mohamad Al-Ali ◽  
Emma Persad ◽  
Andreas Lunacek ◽  
Christof Mrstik ◽  
Eugen Plas
Keyword(s):  
Testosterone Level ◽  
Erectile Function ◽  
Semen Quality ◽  
Semen Analysis ◽  
Serum Testosterone ◽  
T Test ◽  
Serum Testosterone Level ◽  
Testosterone Levels ◽  
Group 2 ◽  
Group 1

Introduction: Many studies suggest that varicoceles are associated with hypogonadism and varicocele repair can increase testosterone levels and improve erectile function.Aim: The aim of this retrospective 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 a clinical varicocele. This group was 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.Main outcome measures: Changes in semen quality, erectile function, and serum hormones 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) (28.6%, 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), and nicotine consumption (p = 0.6) were similar in both the group that saw improvement and the group with no change in semen quality.Conclusion: Semen quality improved in 28.6% of patients after varicocele surgery. Erectile dysfunction (ED) improved after varicocele surgery. We report that lower pre-operative serum testosterone level might be a possible indicator for successful surgical outcome.

scholarly journals Does Varicocelectomy Improve Gonadal Function in Men with Hypogonadism and Infertility? Analysis of a Prospective Study

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Vasan Sathya Srini ◽  
Srinivas Belur Veerachari
Keyword(s):  
Semen Analysis ◽  
Serum Testosterone ◽  
Serum Levels ◽  
Serum Testosterone Level ◽  
Total Testosterone ◽  
Cell Dysfunction ◽  
The Mean ◽  
Group 2 ◽  
A Prospective Study ◽  
Group 1

Varicocele in infertile males is associated with Leydig cell dysfunction and hypogonadism. The effect of varicocelectomy on serum testosterone level is not yet established. We analysed 200 heterosexual infertile men diagnosed to have clinical varicocele they were divided into two groups: group 1 (100 men) had microsurgical varicocelectomy, and group 2 (100 patients) underwent assisted reproduction procedures. All participants had semen analysis, serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and total testosterone (TT), measured both at recruitment time and 6 months later. In group 1, the mean TT level increased significantly after varicocelectomy (1.644±0.029to2.461±0.0198 ng/dL,P<0.0001) and testicular size correlated with the mean change in TT (P=0.001). No similar change was found in group 2. Out of the 100 patients in group 1, 78 had postoperative normalization of TT unlike only 16 men in group 2.

The Majority of Myeloma Patients Are Hypogonadal but This Is Not Associated with High Risk Cytogenetics

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5329-5329
Author(s):  
Beau Snoad ◽  
Samantha Hudzik ◽  
Douglas W Sborov ◽  
Nita Williams ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Conflicts Of Interest ◽  
Serum Testosterone ◽  
Clinic Visit ◽  
Total Testosterone ◽  
Testosterone Levels ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Introduction: Hypogonadism, i.e. low total testosterone, is present in approximately a quarter of men older than 70 years (Harman SM et al, J. Clin Endo & Met, 2001, PMID 11158037 and Wu FCW et al, J Clin Endo & M et, 2008, PMID 18270261). Myeloma patients are known to suffer from fatigue and decreased functional performance, mood disturbances, and anemia; similar trends have been found in people with hypogonadism. Cytogenetically high risk myeloma characterized by the amplification of 1q21 is associated with increased serum levels of soluble IL-6 receptor (sIL-6r) (Stephens OW, Blood, 2012, PMID 22072558). We hypothesized that total testosterone levels will be associated with overall survival from the time of diagnosis, presence of 1q21 amplification by CD138-selected FISH, anemia, and anti-depressant use. Methods: The Buckeye Myeloma Registry (OSU 10115) opened in 2011 to enroll any patient with a plasma cell dyscrasia. Serum total testosterone was measured at the time of the initial clinic visit to the myeloma group at Ohio State. Less than 325 ng/dL was defined as the hypogonadal range, and testosterone was divided into <100 (group 1), 100-240 (group 2), 240-325 (group 3), and greater than 325 ng/dL (group 4), although normal testosterone decreases with age. Female patient testosterone levels were also analyzed and divided into <10 (group 1), 10-60 ng/dL (group 2), and >60 ng/dL (group 3). A retrospective chart review was initiated to review all myeloma patients with a serum testosterone drawn at the time of their initial clinic visit to OSU. Results: Among 418 male MM patients, median age was 65 y.o. (range 24-95), 86% were Caucasian and 14% African-American, and the distribution of ISS stage was 32% stage 1, 22% stage 2, and 19% stage 3 with 28% missing staging data. Cytogenetic data was missing from 28% of patients. Out of 418 male MM patients, 29 (7%) had serum testosterone <100, 202 (48%) with testosterone 100-240, 79 (19%) with testosterone 241-325, and 108 (26%) > 325 ng/dL. Out of 172 female MM patients, 44 (26%) had an undetectable serum testosterone, 120 (70%) with testosterone 10-60, and 8 (5%) with testosterone > 60. Among male MM patients, log-rank [Mantel-Cox] analysis of overall survival with serum testosterone including all 4 groups demonstrated no significant differences (p=0.917) with only 80 events. Among 275 male MM patients with cytogenetic information available, there was no correlation between presence of 1q21 trisomies or tetrasomies and overall survival (r=0.0714, p=0.238). There was a strong and expected correlation between testosterone and BMI (r=0.14, p=0.00468). Among 161 total female MM patients, log-rank analysis with serum testosterone including all 3 groups also demonstrated no differences (p=0.416) with only 29 events in total. Among 101 females with cytogenetic information, there was also no correlation with 1q21 amplification (r=0.0895, p=0.373). Conclusion: The majority of male MM patients (74%) have secondary hypogonadism and approximately half have total testosterone levels <240 ng/dL. Cox proportional hazards analyses of survival adjusted for significant univariate covariates will be presented at the meeting. Correlations with anemia and medication use (specifically opiates and anti-depressants) will also be presented at the meeting. Disclosures No relevant conflicts of interest to declare.

Serum testosterone level and overall survival in first-line abiraterone and enzalutamide for metastatic castration-resistant prostate cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17545-e17545
Author(s):  
Maysa Tamara Silveira Vilbert ◽  
Marcelle Goldner Cesca ◽  
Natasha Carvalho Pandolfi ◽  
Vinicius Fernando Calsavara ◽  
Bruno Cezar de Mendonça Uchôa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Testosterone Level ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Testosterone Levels ◽  
Castration Resistant ◽  
Low Serum

e17545 Background: Androgen receptor-targeted agents Abiraterone and Enzalutamide (Abi/Ez) prolonged overall survival in metastatic castration resistant prostate cancer (mCRPC). Patients with very-low serum testosterone levels seem to have less benefit from these therapies as well as more aggressive prostate cancer. Methods: A retrospective observational cohort study was conducted to evaluate whether a serum testosterone measured at time of start first-line therapy with Abi/Ez is related to overall survival (OS) and time-to-treatment failure (TTF) in mCRPC patients. Kaplan-Meier survival estimates and Cox-regression models were used for time-to-event analyses. The best cut-off for testosterone was defined using Log-rank statistics (Lausen and Schumacher). X² test and Mann-Whitney U-test were applied to compare categorical and continuous variables, respectively. Logistic regression was used to assess characteristics related to serum testosterone levels. Statistical significance was fixed at 0.05. Results: From May 2012 to February 2017, 100 patients were assessed. Median follow-up was 27.8 months (range 2.23 to 68.26). Pts with a high testosterone level ( > 28.2; n = 20) achieved a significantly higher OS (median 66.0 vs 31.9 mo, testosterone > 28.2 HR: 0.206, 95% CI 0.074 to 0.571, p = 0.002) and TTF (median 30.6 vs 11.8 mo, testosterone > 28.2 HR: 0.408, 95%CI 0.219 to 0.762, p = 0.005) than pts with a low serum testosterone level ( < 28.2; n = 80), regardless of receiving therapy with either Abi (n = 69) or Ez (n = 31). Pts with a higher testosterone level were younger (median 67.7 vs 73.6 years; p = 0.026), had a higher body mass index (BMI) (28.5 vs 25.9, p = 0.023) and a lower PSA at start Abi/Ez (12 vs 26, p = 0.031) than pts with lower values. Age (OR 0.93, 95%CI 0.8 to 0.9, p = 0.021), BMI (OR 1.21, 95%CI 1.1 to 1.4, p = 0.006) and baseline PSA (OR 1.2, 95%CI 1.03 to 1.4, p = 0.020) were significantly associated with testosterone > 28.2. After 4 months of Abi/Ez treatment, PSA decrease > 50% of baseline was seen more frequently in high testosterone levels group than in low testosterone levels pts (90% vs 57.5% of pts, respectively, p = 0.007). Conclusions: Pts with high levels of testosterone ( > 28.2) achieved a better OS and TTF when treated with Abi/Ez in first-line mCRPC than those with low levels. Testosterone can be considered a prognostic and predictive biomarker in this scenario, and could be used in treatment decision for this population.

scholarly journals Influence of Preoperative Pain Duration on Microsurgical Varicocelectomy Outcomes

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Mustafa Gökhan Köse ◽  
Kadir Önem ◽  
Mehmet Çetinkaya ◽  
Erkan Karadağ ◽  
Emre Arpali
Keyword(s):  
Semen Quality ◽  
Semen Analysis ◽  
Sperm Concentration ◽  
Sexual Abstinence ◽  
Preoperative Pain ◽  
Intergroup Comparison ◽  
Pain Duration ◽  
Group 2 ◽  
Grade 3 ◽  
Group 1

Objective. To investigate the question of whether duration of pain before surgery ultimately affects sperm parameters after varicocelectomy.Methods. Fifty patients with painful grade-3 varicocele were investigated prospectively. The patients were divided into two groups according to their symptom period. The patients having had grade-3 varicocele for less than 1 year were included in Group-1 (Ge,n=25). Twenty-five patients who had painful grade-3 varicocele for more than 1 year (Gs,n=25) were classified in Group-2. Semen analysis was performed after 3 days of sexual abstinence twice a month. Total sperm concentration (TSC), rapidly progressive motility (SPa), and slow or sluggish motility (SPb) rates were noted. Pain was evaluated by using 10 cm visual analogue scale (VAS).Results. Postoperative TSC and %SPb were significantly higher in both groups (P=0.01). There was no difference between two groups for preoperative and postoperative TSC, %SPa, % and SPb values. VAS significantly declined in both groups (P=0.005). This postoperative decline was not significant for intergroup comparison.Conclusions. Our results show that increase in semen quality and decrease in the pain after microsurgery varicocelectomy do not depend on the duration of the preoperative pain.

scholarly journals Prepubertal Serum Testosterone Concentration In Vembur Rams At Different Rearing System

2017 ◽  
Vol 12 (4) ◽  
Author(s):  
R. Selvakkumar ◽  
T. Sivakumar ◽  
S. Ganesh Kumar ◽  
P. Anuradha
Keyword(s):  
Field Condition ◽  
Testosterone Level ◽  
Serum Testosterone ◽  
Serum Testosterone Level ◽  
Testosterone Concentration ◽  
Testosterone Levels ◽  
Ram Lambs ◽  
Age At Puberty

The present investigation was carried out to study the prepubertal testosterone pattern and age at puberty in Vembur rams reared under farm and farmers field condition. A total number of 8 Vembur ram lambs each from farm and farmers field were selected. The measurement of testosterone was performed by Radioimmunoassay (RIA). The serum testosterone level from 6th to 20th month of age ranged from 0.132 ± 0.04 to 3.823 ng/ml in semi intensively maintained farm males and 0.138±0.04 to 3.456±0.17 ng/ml in animals maintained at farmer’s holdings. The serum testosterone levels were crossing the concentration of 2.5 ng/ml at the age of 17 to 18th weeks and successful mounting, intromission and ejaculation were noticed after this age.

scholarly journals Testosterone therapy: Prescribing and monitoring patterns of practice in British Columbia

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Jennifer A. Locke ◽  
Ryan Flannigan ◽  
Oliver P. Günther ◽  
Sean Skeldon ◽  
S. Larry Goldenberg
Keyword(s):  
British Columbia ◽  
Testosterone Level ◽  
Serum Testosterone ◽  
Population Based ◽  
Further Education ◽  
Serum Testosterone Level ◽  
Dose Titration ◽  
Testosterone Therapy ◽  
Testosterone Levels ◽  
Prescribing Practice

Introduction: Guidelines recommend that testosterone therapy (TTh) be restricted to men with a biochemical diagnosis of hypogonadism, and that therapeutic responses be titrated within the normal range. Methods: Using four provincial longitudinal databases in British Columbia, we identified men prescribed TTh (1997–2013). We characterized the prescribing and monitoring practices of TTh in the context of serum testosterone levels drawn prior to and following initiation of TTh in a population-based setting. Results: In our analysis of 37 741 men who received at least one TTh prescription, 48% received injectable testosterone and the vast majority were treated by general practitioners. The number of prescriptions for men increased annually, particularly after 2008; 40% discontinued their treatment after their first or second prescription, while 27% received more than 10 repeats. The absolute percentage of pre- and post-serum testosterone levels ordered increased by 16% and 31% during the study period, respectively. However, after initiating TTh, only 36% of all the men had a followup serum testosterone level drawn. Of those with low serum testosterone levels prior to TTh, 49% remained biochemically hypogonadal following TTh, suggesting non-compliance or inadequate dosing. Conclusions: Many men prescribed TTh did not continue beyond a short trial. While the practice of checking pre-and post-TTh testosterone levels has improved over the study period, it is concerning that only one-third had a followup serum testosterone level, and half remained biochemically low. Further education is required around TTh prescribing, dose titration, and monitoring to ensure both effective and safe prescribing practice.

scholarly journals Estimate the level of testosterone hormone using I-chroma technique in males treated with Royal jelly and honeybee

2021 ◽  
Vol 4 (1) ◽  
pp. 16-18
Author(s):  
Baqer Hassan ◽  
Zainab Fadhil Abbas
Keyword(s):  
Testosterone Level ◽  
Royal Jelly ◽  
Serum Testosterone ◽  
Treated Group ◽  
Serum Testosterone Level ◽  
Control Group ◽  
Short Term Treatment ◽  
Testosterone Levels ◽  
Natural Treatment ◽  
Result Show

The experiment based on 10 matured men samples collected randomly from Baghdad Providence. The 10 samples divided into two groups, serum testosterone level of all 10 patient had been done using Ichroma technique. the treated group administered 2.5ml of honeybee with 350mg of royal jelly daily for (15day) while the second group stay as control group. After 15 days blood samples had been collected and serum separated to made another testosterone test for both groups using same i-chroma technique. The main Aim of this study is estimating the effect of royal jelly and honeybee as food on the testosterone hormone level in men. The result show that there was significant increase in the testosterone levels in treated group in comparison with control group. after experiment the result show significant increase in testosterone levels (in samples number 1,2,3,4 and 5) as the following (23.2 n.mo/L, 16.6 n.mo/L, 17.7 n.mo/L, 10.1 n.mo/L and 29.7 n.mo/L respectively. The study concluded that, short term treatment of royal jelly in combined with honey bee increasing the level of blood testosterone hormone in men in different ages significantly. The study either concluded that we can used honeybee and royal jelly as natural treatment of low testosterone level in men.

scholarly journals Post-COVID-19 transient hypogonadism and erectile dysfunction

2021 ◽  
Vol 14 (3) ◽  
pp. 112-118
Author(s):  
F.R. Asfandiyarov ◽  
◽  
V.A. Kruglov ◽  
S.V. Vybornov ◽  
K.S. Seidov ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Testosterone Level ◽  
Erectile Function ◽  
Hormone Replacement ◽  
Severe Illness ◽  
Hormonal Profile ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Introduction. The SARS-CoV-2 virus pandemic is one of the biggest public health challenges in the modern era. Currently, along with the continuing high incidence rate, the immediate and long-term consequences of COVID-19 are predictably becoming increasingly important. The impact of the COVID-19 on andrological health and erectile function has been studied insufficiently. The aim of this study was to assess the impact of COVID-19 infection on erectile function. Material and methods. From May 2020 to April 2021 44 men after COVID-19 pneumonia were consulted for decrease in libido, erectile function and the quality of sexual intercourse in three Astrakhan medical centers. The examination of patients included standard general clinical methods, hormonal profile studying (testosterone, luteinizing homone, prolactin) and number of standardized questionnaires. Results. No changes in the levels of luteinizing hormone and prolactin were observed. Total testosterone levels ranged from 8.0 to 14.8 nmol / L. According the testosterone level patients were divided into two groups. In group 1 patients testosterone level was 12.0 nmol/L and more, in group 2 patients – less than 12 nmol/L. In patients of the group 1 erectile dysfunction was regarded as one of the manifestations of asthenic syndrome and was relatively easily corrected by the administration of PDE-5 inhibitors and antiasthenic therapy. Patients of the group 2 had more severe complaints, «worse» scores on questionnaire scales and more significant asthenic syndrome. Discussion. The possible mechanisms of androgen deficiency and hormonal profile changes in those patients may be a direct damaging of gonadal cells by virus and nonspecific suppression of the hypothalamic-pituitary system caused by a severe illness. In some cases, testosterone preparations were prescribed to those patients to achieve a therapeutic effect. Conclusions. COVID infection may have a negative impact on erectile function. The main causes of this are decrease of testosterone level, endothelial dysfunction, and long-term asthenization. Those changes may be reversible by rehabilitation and drug correction. One should not rush to begin hormone replacement therapy. It makes sense to start treatment with antiasthenic drugs, and add testosterone preparations in the absence of an effect only. This study addresses only some aspects of the COVID-19 influence on the men's health. In the context of the ongoing pandemic and the inevitable increase in the number of ill patients, further comprehensive studies are needed to clarify all the details and organize adequate andrological care for these patients.

scholarly journals Effects of Aromatase Inhibition in Elderly Men with Low or Borderline-Low Serum Testosterone Levels

2004 ◽  
Vol 89 (3) ◽  
pp. 1174-1180 ◽  
Author(s):  
Benjamin Z. Leder ◽  
Jacqueline L. Rohrer ◽  
Stephen D. Rubin ◽  
Jose Gallo ◽  
Christopher Longcope
Keyword(s):  
Short Form ◽  
Specific Antigen ◽  
Serum Testosterone ◽  
Total Testosterone ◽  
Elderly Men ◽  
Symptom Index ◽  
Testosterone Levels ◽  
Group 2 ◽  
American Urological Association ◽  
Group 1

Abstract As men age, serum testosterone levels decrease, a factor that may contribute to some aspects of age-related physiological deterioration. Although androgen replacement has been shown to have beneficial effects in frankly hypogonadal men, its use in elderly men with borderline hypogonadism is controversial. Furthermore, current testosterone replacement methods have important limitations. We investigated the ability of the orally administered aromatase inhibitor, anastrozole, to increase endogenous testosterone production in 37 elderly men (aged 62–74 yr) with screening serum testosterone levels less than 350 ng/dl. Subjects were randomized in a double-blind fashion to the following 12-wk oral regimens: group 1: anastrozole 1 mg daily (n = 12); group 2: anastrozole 1 mg twice weekly (n = 11); and group 3: placebo daily (n = 14). Hormone levels, quality of life (MOS Short-Form Health Survey), sexual function (International Index of Erectile Function), benign prostate hyperplasia severity (American Urological Association Symptom Index Score), prostate-specific antigen, and measures of safety were compared among groups. Mean ± sd bioavailable testosterone increased from 99 ± 31 to 207 ± 65 ng/dl in group 1 and from 115 ± 37 to 178 ± 55 ng/dl in group 2 (P &lt; 0.001 vs. placebo for both groups and P = 0.054 group 1 vs. group 2). Total testosterone levels increased from 343 ± 61 to 572 ± 139 ng/dl in group 1 and from 397 ± 106 to 520 ± 91 ng/dl in group 2 (P &lt; 0.001 vs. placebo for both groups and P = 0.012 group 1 vs. group 2). Serum estradiol levels decreased from 26 ± 8 to 17 ± 6 pg/ml in group 1 and from 27 ± 8 to 17 ± 5 pg/ml in group 2 (P &lt; 0.001 vs. placebo for both groups and P = NS group 1 vs. group 2). Serum LH levels increased from 5.1 ± 4.8 to 7.9 ± 6.5 U/liter and from 4.1 ± 1.6 to 7.2 ± 2.8 U/liter in groups 1 and 2, respectively (P = 0.007 group 1 vs. placebo, P = 0.003 group 2 vs. placebo, and P = NS group 1 vs. group 2). Scores for hematocrit, MOS Short-Form Health Survey, International Index of Erectile Function, and American Urological Association Symptom Index Score did not change. Serum prostate-specific antigen levels increased in group 2 only (1.7 ± 1.0 to 2.2 ± 1.5 ng/ml, P = 0.031, compared with placebo). These data demonstrate that aromatase inhibition increases serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism. Serum estradiol levels decrease modestly but remain within the normal male range. The physiological consequences of these changes remain to be determined.

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