Is there a relationship between varicocele and testosterone levels?

OBJECTIVES: The goal of this work was to study the relationship between presence of varicocele and testosterone serum levels in adulthood. METHODS: A comparative, cross-sectional study of 387 men who consulted for erectile dysfunction. Age, body mass index (BMI), diabetes (DM), and presence of varicocele were related to testosterone levels through uni- and multi-variate analysis. RESULTS: A total of 248 cases (70.8%) had no varicocele, 46 (13.1%) had grade I varicocele, 36 (10.3%) grade II, and 20 (5.7%) grade III. The mean total testosterone levels were 4.77 ng/mL in the non-varicocele group and 4.34 ng/mL in the varicocele group (p = .91), while free testosterone levels were 69.81 and 73.24 pg/mL (p = .18), respectively. In the multivariate analysis, BMI> = 30 was related to low total testosterone levels (OR: 2.94, p < .001) and low free testosterone (OR: 2.01, p = .01), while advanced age associated with low levels of free testosterone (OR: 1.04, p < .001). CONCLUSIONS: We were not able to establish a relationship between the presence of varicocele and decreased serum testosterone levels. Other factors already described, such as obesity and age, were related to low levels of total and free testosterone.

Cardiovascular risk assessment using high-sensitivity C-reactive protein in patients with erectile dysfunction.

BACKGROUND: Erectile dysfunction (ED) is associated with cardiovascular events. High-sensitivity C-reactive protein (hsCRP) is a cardiovascular risk marker. The aim of this study is to determine whether hsCRP is useful in evaluating ED. METHODS: In 121 patients with ED, age, ED type and severity, time since onset of ED, weight, height, BMI, body fat percentage, waist and hip circumference, hsCRP and hormone profile were studied. Patients were classified as low or moderate-high cardiovascular risk based on hsCRP levels. A descriptive and univariate study was performed. A logistic regression was used to establish factors associated with low versus moderate-high cardiovascular risk and hsCRP. RESULTS: Most patients had moderate-severe ED (70%). 74% had a moderate-high cardiovascular risk based on hsCRP levels, and 33.9 and 34.7% had hypogonadism according to total (TT) and free testosterone. In the univariate analysis, a relationship between hsCRP and TT and physical examination variables was observed (p < 0.05). In the multivariate analysis, TT was found to be a predictor (OR: 0.676; 95% CI: 0.491-0.029). Higher cardiovascular risk was found in the hypogonadic group (OR: 5.51; 95% CI: 1.185-25.662) and waist- to-hip ratio (p = 0.008; OR: 1.361; 95% CI: 1.075-1.612). CONCLUSIONS: A majority of patients with ED have high cardiovascular risk based on hsCRP levels and there is an association with hypogonadism and obesity.

[Mitomycin extravasation after postoperative instillation]. / EXTRAVASACIÓN DE MITOMOICINA TRAS INSTALACIÓN POSTOPERATORIA.

OBJECTIVE: To present the therapeutic management of severe complications related to postoperative mitomycin extravasation. METHODS: Description of clinical cases, medical and surgical management and pathologic results of surgical specimens. RESULTS: We report two cases of patients with extravesical mitomycin leakage after postoperative instillation. No bladder perforation was evident during tumor surgery. In both cases radical cystectomy was required. CONCLUSIONS: Postoperative mitomycin instillation may have undesirable consequences. The possible problems derived from its administration must be known, and each case must be individualized before administering this chemotherapy.