Testicular hypotrophy twice as common in men with varicoceles

Testicular hypotrophy in adult infertile men is about two times more common in patients with varicoceles than in those withoutvaricoceles, researchers from Brown University, Providence, RI, reported at the AUA annual meeting.

The researchers examined office records of 3,927 adult patients presenting for male infertility evaluation between 1989 and2007. Patients with a history of vasectomy, orchiectomy, mumps, cryptorchidism, radiation, chemotherapy, testicular trauma, oranabolic steroid use were excluded, leaving 3,202 men for the analyses. Of these men, 705 (22%) had testicular hypotrophy,defined as a testicular size discrepancy greater than 3 mL, and 1,105 (34%) presented with a clinical varicocele.

Testicular hypotrophy was found in 32% of men with any varicocele versus in only 17% of men without varicocele. The data alsoshowed that left-sided testicular hypotrophy was more common than right-sided testicular hypotrophy, regardless of the side ofthe varicocele. Left-sided hypotrophy was found in 30% of men with a left varicocle compared to only 13% of men with novaricocele. Among the 287 men with a left varicocele and hypotrophy, the hypotrophy was left-sided 89% of the time and on theright side 11% of the time. In the small population of 5 men with a right varicocele and hypotrophy, all men had hypotrophy onthe left side.

Explaining the motivation for the study, Sutchin R. Patel, MD, said, "Testicular hypotrophy is a well-recognized finding inpatients with varicoceles, and while it also occurs in patients without varicoceles, the relative prevalence compared topatients with varicoceles is unknown.

"Understanding why the size of one testicle is affected more than the other and of the association of right varicocele withleft-sided hypotrophy are topics requiring more study."