Recently a patient came to me because he and his wife couldn´t have a child. As a part of his evaluation, I took a history of his chief complaint and a physical exam. At that point I found that he had a varicocele. Varicocele is like its name suggests an inflammation of the veins that leave the testes; and of course the number one cause of infertility that could be treated. But also as a part of his evaluation I performed some blood tests and images studies and confirm my diagnosis, but I also noticed he had his testosterone levels a bit low at that point, a result that I found very interesting.
It is known that varicocele causes diminish on the spermatic production: the spermatic veins leaving the testicles form a communicating meshwork of veins that produces a counter-current heat-exchange mechanism to cool the arterial blood.
This mechanism is eliminated in patients with varicocele, causing elevated scrotal temperatures. But also it some controversial information about the alteration that varicocele causes on the other types of cells on the testes and causing a hormonal dysfunction, as a consequence reduction of serum testosterone concentration.
In the latest issue of the International Journal of Urology, there is an article that evaluates the effect of varicocele repair on fertility and testosterone production. They review different articles and conclude that the surgical treatment of aricocele significantly increases testosterone production and improves testicular function.
I did a microsurgical repair of my patient´s Varicocele and of course now he has a normal spermatic production and a great chance to be a father. We are waiting for his testosterone results in a few months, but according to the new information it´ll improves.
So if you have an infertility problem please do not doubt to seek for help, we must rule out varicocele and others causes. For more information send me an e-mail to lnunez@urozen.com.
Luciano Nunez M.D.
Urologist
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