Objective
To evaluate whether varicocelectomy improves both serum testosterone and sexual function,
as assessed by the Male Sexual Health Questionnaire (MSHQ).
Methods
A retrospective chart review of patients who have undergone varicocelectomy and had
both pre- and postoperative MSHQ was performed. The MSHQ is a clinically validated
questionnaire that assesses erectile function, ejaculatory function, and sexual satisfaction,
with higher scores indicating better function. Clinical parameters pre and postvaricocelectomy
were compared with paired t test.
Results
Thirty-four patients met study criteria. Seventeen patients (50%) presented for infertility,
and the remaining 13 had symptomatic varicocele associated with hypogonadism. Average
postsurgical follow-up was 20.6 ± 12.5 months. The majority of men in the study had
bilateral varicoceles and left grade III varicoceles. Significant improvements in
the total MSHQ score (3.9 ± 8.7, P = .027), the MSHQ erectile function (1.2 ± 2.3, P = .007), and the MSHQ ejaculatory function (1.4 ± 3.1, P = .018) domains were seen. Fifteen (44%) men saw improvement in their erectile function
and 18 (53%) saw improvement in ejaculatory function. The improvement in serum testosterone
was also significant (136.0 ± 201.3 ng/dL, P = .007).
Conclusion
Microsurgical repair of varicocele not only improves testosterone, but also improves
patient-reported erectile and ejaculatory functions. Patients can confidently be counseled
that varicocelectomy has the potential to improve sexual function along with serum
testosterone.
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Article info
Publication history
Published online: May 16, 2016
Accepted:
April 4,
2016
Received:
September 23,
2015
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Funding Support: This project was supported by grant number T32HS00066 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. The project was also supported by The Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust.
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© 2016 Elsevier Inc. All rights reserved.
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- Re: Najari et al: Improvements in Patient-reported Sexual Function After Microsurgical Varicocelectomy (Urology 2017;110:104-109)UrologyVol. 115
- PreviewI read the article by Najari et al,1 which demonstrated the improvements in testosterone level and patient-reported sexual function after microsurgical repair of varicocelectomy with great interest. Najari et al used the Male Sexual Health Questionnaire (MSHQ) to assess the pre- and postoperative sexual functioning along with serum testosterone and luteinizing hormone levels. However, I want to highlight some issues related to this article. First of all, the patient cohort is heterogeneous such that 50% of them presented with infertility and the remaining 50% presented with sexual dysfunction, including erectile dysfunction and diminished libido.
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