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Impact of varicocele on biological markers of gonadal function

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Abstract

Purpose

The aim of this study is to evaluate the potential effect of varicocele in the hormonal and clinical profile of adolescents.

Methods

Twenty adolescents at Tanner stage 4–5 with left varicocele were studied and compared with a control group of 20 healthy adolescents. All patients underwent ultrasonographic testicular volumetry as well as hormonal evaluation of inhibin B, testosterone, baseline and gonadotropin-releasing hormone stimulated, follicle-stimulating hormone as well as luteinizing hormone. Statistical analysis was performed using the student’s t test with p value <0.05 taken as statistical significant.

Results

Patients with varicocele showed reduced levels of inhibin B compared to controls and a significant reduction in the testicular volume on the affected side. The response of luteinizing hormone to gonadotropin-releasing hormone stimulation was significantly higher in the varicocele group compared to the control group. Furthermore a significant inverse relationship of inhibin B compared to follicle-stimulating hormone was noted.

Conclusion

Serum inhibin B levels could represent a useful marker of Sertoli cell damage caused by varicocele.

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References

  1. Akbay E, Cayan S, Doruk E, Duce MN, Bozlu M (2000) The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents. BJU Int 86:490–493

    Article  CAS  PubMed  Google Scholar 

  2. Camoglio FS, Cervellione RM, Dipaola G, Balducci T, Giacomello L, Zanatta C, Forestieri C, Chironi C (2001) Idiopathic varicocele in children. Epidemiological study and surgical approach. Minerva Urol Nefrol 53:189–193

    CAS  PubMed  Google Scholar 

  3. Al-Abbadi K, Smadi SA (2000) Genital abnormalities and groin hernias in elementary-school children in Aqaba:an epidemiological study. East Mediter Health J 6:293–298

    CAS  Google Scholar 

  4. Hwang Y, Park SW (2009) Epidemiologic study of the prevalence and awareness of cryptorchidism, hydrocele, and varicocele in elementary schools in Gwangju. Korean J Urol 50:278–281

    Article  Google Scholar 

  5. Belloli G, D’Agostino S, Pesce C, Fantuz E (1993) Varicocele in childhood and adolescence and other testicular anomalies: an epidemiological study. Pediatr Med Chir 15:159–162

    CAS  PubMed  Google Scholar 

  6. Skoog SJ, Roberts KP, Goldstein M, Pryor JL (1997) The adolescent varicocele: what’s new with an old problem in young parients? Pediatrics 100:112–121

    Article  CAS  PubMed  Google Scholar 

  7. Male infertility best practice policy committee of the American Urological Association (2004) Report on varicocele and infertility. Fertil Steril 82(Suppl):S1 42–S145

  8. Kass EJ, Freitas JE, Salisz JA, Steinert BW (1993) Pituitary gonadal dysfunction in adolescents with varicocele. Urology 42:179–181

    Article  CAS  PubMed  Google Scholar 

  9. Romeo C, Arrigo T, Impellizzeri P, Manganaro A, Antonuccio P, Di Pasquale G, Messina MF, Marseglia L, Formica I, Zuccarello B (2007) Altered serum inhibin B levels in adolescents with varicocele. J Ped Surg 42:390–394

    Article  Google Scholar 

  10. Dubin L, Amelar RD (1970) Varicocele size and results of varicocele in selected subfertile men with varicocele. Fertil Steril 21:606–609

    Article  CAS  PubMed  Google Scholar 

  11. Marshall WA, Tanner JM (1970) Variations of pubertal changes in boys. Arch Dis Child 45:13–23

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Trigo RV, Bergada I, Rey R, Ballerini MG, Bedecarras P, Bergada C, Gottlieb S, Campo S (2004) Altered serum profile of inhibin B, pro-alphaC and anti-mullerian hormone in prepubertal and pubertal boys with varicocele. Clin Endocrinol 60:758–764

    Article  CAS  Google Scholar 

  13. Burger HG (1992) Inhibin. Reprod Med Rev 1:1–20

    Article  Google Scholar 

  14. McLachan RI, Matsumoto AM, Burger HG, De Kretser DM, Bremner WJ (1988) Relative roles of follicle-stimulating hormone and luteinizing hormone in the control of inhibin secretion in normal men. J Clin Investig 82:880–884

    Article  Google Scholar 

  15. Sharpe RM, Kerr JB, Maddocks S (1988) Evidence for a role of the Leydig cells in control of the intratesticular secretion of inhibin. Mol Cell Endocrinol 2–3:243–247

    Article  Google Scholar 

  16. Andersson AM, Juul A, Petersen JH, Muller J, Groome NP, Skakkebaek NE (1997) Serum inhibin B in healthy pubertal and adolescent boys: relation to age, stage of puberty, and folliclestimulating hormone, luteinizing hormone, testosterone, and estradiol levels. J Clin Endocrinol Metab 82:3976–3981

    CAS  PubMed  Google Scholar 

  17. Calsen E, Giwercman A, Skakkabaek NE, Keiding N (1992) Decreasing quality of semen. BMJ 305(6854):609–613

    Article  Google Scholar 

  18. Illingworth PJ, Groome NP, Bryd W, Rainey WE, McNeilly AS, Mather JP, Bremner WJ (1996) Inhibin B: a likely candidate for the physiologically important form of inhibin in man. J Clin Endocrinol Metab 81:1321–1325

    CAS  PubMed  Google Scholar 

  19. Ponchietti R, Raugai A, Grachi G (1987) Ultrastructural changes of Leydig cells in prepubertal varicocele. Acta Eur Fertil 18:347–348

    CAS  PubMed  Google Scholar 

  20. Haans LC, Laven JS, Mali WP, Te Velde ER, Wensing CJ (1991) Testis volumes, semen quality, and hormonal patterns in adolescents with and without a varicocele. Fertil Steril 56:731–736

    Article  CAS  PubMed  Google Scholar 

  21. Steeno O, Knops J, Declerck L, Adimoelja A, Van de Voorde H (1976) Prevention of fertility disorders by detection and treatment of varicocele at school and college age. Andrologia 8:47–53

    Article  CAS  PubMed  Google Scholar 

  22. Lyon RP, Marshall S, Scott MP (1982) Varicocele in childhood and adolescence: implication in adult fertility. Urology 19:641–644

    Article  CAS  PubMed  Google Scholar 

  23. Paduch DA, Niedzielski J (1997) Repair versus observation in adolescent varicocele: a prospective study. J Urol 158:1128–1132

    Article  CAS  PubMed  Google Scholar 

  24. Sayfan J, Siplovich L, Koltun L, Benyamin N (1997) Varicocele treatment in pubertal boys prevents testicular growth arrest. J Urol 157:1456–1457

    Article  CAS  PubMed  Google Scholar 

  25. Guarino N, Tadini B, Bianchi M (2003) The adolescent varicocele: the crucial role of hormonal tests in selecting patients with testicular dysfunction. J Pediatr Surg 38:120–123

    Article  PubMed  Google Scholar 

  26. Liu MJ, Wang EH (2014) Impact of varicocele on semen quality and inhibin B concentration in serum and seminal plasma. Zhonghua Nan Ke Xue 20:44–47

    CAS  PubMed  Google Scholar 

  27. Romeo C, Arrigo T, Impellizzeri P, Manganaro A, Antonuccio P, Di Pasquale G, Messina MF, Marseglia L, Formica I, Zuccarello B (2007) Altered serum inhibin B levels in adolescents with varicocele. J Ped Surg 42:390–394

    Article  Google Scholar 

  28. Hayes FJ, Hall JE, Boepple PA, Crowley WF (1998) Clinical review 96: differential control of gonadotropin secretion in the human: endocrine role of inhibin. J Clin Endocrinol Metab 83:1835–1841

    CAS  PubMed  Google Scholar 

  29. Foresta C, Bettella A, Rossato M, La Scala G, De Paoli M, Plebani M (1999) Inhibin B plasma concentration in oligozoospermic subjects before and after therapy with follicle stimulating hormone. Hum Reprod 14:906–912

    Article  CAS  PubMed  Google Scholar 

  30. Castro-Magana M, Angulo M, Canas A, Uy J (1990) Leydig cell function in adodescent boys with varicoceles. Arch Androl 24:73–79

    Article  CAS  PubMed  Google Scholar 

  31. Anyfantakis D, Symvoulakis EK, Barbounakis E, Kastanakis M, Athanasakis E, Blevrakis E, Kastanakis S (2014) A fatal case of seronegative, late-onset systemic lupus erythematosus presenting with motor sensory axonal polyneuropathy. Mod Rheumatol 24:858–861

    Article  CAS  PubMed  Google Scholar 

  32. Anyfantakis D, Symvoulakis EK (2011) Medical decision and patient’s preference: ‘much ethics’ and more trust always needed. Int J Med Sci 8:351–352

    Article  PubMed  PubMed Central  Google Scholar 

  33. Schiff J, Kelly C, Goldstein M, Schlegel P, Poppas D (2005) Managing varicoceles in children: results with microsurgical varicocelectomy. BJU Int 95:399–402

    Article  PubMed  Google Scholar 

  34. Haddad NG, Houk CP, Lee PA (2014) Varicocele: a dilemma in adolescent males. Pediatr Endocrinol Rev 2:274–283

    Google Scholar 

  35. Diamond DA, Gargollo PC, Caldamone AA (2011) Current management principles for adolescent varicocele. Fert Steril 96:1294–1298

    Article  Google Scholar 

  36. Waalkes R, Manea IF, Nijman JM (2012) Varicocele in adolescents: a review and guideline for the daily practice. Arch Esp Urol 65:859–871

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, University Hospital of Heraklion, Crete, Greece

    E. Blevrakis & G. Sakellaris

  2. Department of Urology, Iaso General Hospital, Athens, Greece

    E. Chatzidarellis

  3. Primary Health Care Centre of Kissamos, Chania, Crete, Greece

    D. Anyfantakis

  4. Department of Radiology, University Hospital of Heraklion, Crete, Greece

    M. Raissaki

  5. Department of Surgical Oncology, University Hospital of Heraklion, Crete, Greece

    O. Zoras

  6. Department of Urology, University Hospital of Heraklion, Crete, Greece

    C. Mamoulakis & F. Sofras

  7. Department of General Surgery, University Hospital of Heraklion, Crete, Greece

    E. Chrysos

Authors
  1. E. Blevrakis
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  2. E. Chatzidarellis
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  3. D. Anyfantakis
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  4. G. Sakellaris
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Corresponding author

Correspondence to E. Blevrakis.

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Blevrakis, E., Chatzidarellis, E., Anyfantakis, D. et al. Impact of varicocele on biological markers of gonadal function. Hernia 20, 435–439 (2016). https://doi.org/10.1007/s10029-015-1361-x

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  • DOI: https://doi.org/10.1007/s10029-015-1361-x

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