Relationship between varicocele, sexual dysfunction and serum testosterone levels

Introduction: the relationship of varicocele with erectile sexual dysfunction and testosterone concentration has not been fully elucidated. Objective: to assess the possible relationship between the presence of varicocele, testosterone serum levels and erectile sexual dysfunction. Method: a cross-sectional study was conducted in Pinar del Río, during the years 2014-2017. The correlation between the presence of varicocele and erectile sexual dysfunction was established. Testosterone levels were compared in patients with and without varicocele. For categorized variables, the X2 test was applied. The quantitative variables were compared using the t-Student test. The analyses were performed with SPSS 23 software and a 95% certainty. Results: the prevalence in patients with varicocele was 38.6% and in those who did not suffer from it, it was 26.1%. Chi square test (X2 = 6.5, p = 0.01) showed a significant association between both entities and the inconsistency ratio shows a slight increase in the risk of suffering from erectile sexual dysfunction in case of varicocele, OR = 1.7 95% CI = 1.14-2.78. The mean testosterone serum concentration was lower in patients with varicocele (11.8 nmol / L versus 16.1 nmol / L). The t-Student test (t = 5.6, p = 0.00) showed a significant difference in both groups in relation to the determinations of this hormone. Conclusions: these findings suggest varicocele might be involved in the occurrence of sexual dysfunction due to decreased levels of testosterone

Relación entre varicocele, disfunción sexual y niveles séricos de testosterona

Introduction: the relationship of varicocele with erectile sexual dysfunction and testosterone concentration has not been fully elucidated.Objective: to assess the possible relationship between the presence of varicocele, testosterone serum levels and erectile sexual dysfunction.Method: a cross-sectional study was conducted in Pinar del Río, during the years 2014-2017. The correlation between the presence of varicocele and erectile sexual dysfunction was established. Testosterone levels were compared in patients with and without varicocele. For categorized variables, the X2 test was applied. The quantitative variables were compared using the t-Student test. The analyses were performed with SPSS 23 software and a 95% certainty.Results: the prevalence in patients with varicocele was 38.6% and in those who did not suffer from it, it was 26.1%. Chi square test (X2 = 6.5, p = 0.01) showed a significant association between both entities and the inconsistency ratio shows a slight increase in the risk of suffering from erectile sexual dysfunction in case of varicocele, OR = 1.7 95% CI = 1.14-2.78. The mean testosterone serum concentration was lower in patients with varicocele (11.8 nmol / L versus 16.1 nmol / L). The t-Student test (t = 5.6, p = 0.00) showed a significant difference in both groups in relation to the determinations of this hormone.Conclusions: these findings suggest varicocele might be involved in the occurrence of sexual dysfunction due to decreased levels of testosterone.Introducción: la relación del varicocele con la disfunción sexual eréctil y la concentración de testosterona no ha sido totalmente esclarecida. Objetivo: evaluar la posible relación entre la presencia de varicocele, los niveles plasmáticos de testosterona y la disfunción sexual eréctil. Método: se realizó un estudio transversal en Pinar del Río, entre los años 2014-17. Se estableció la correlación entre la presencia del varicocele y la disfunción sexual eréctil.  Se compararon los niveles de testosterona en los pacientes con y sin varicocele. Para las variables categorizadas se utilizó la prueba de X2. Las variables cuantitativas se compararon mediante la prueba t de Student. Los análisis fueron realizados con el software SPSS 23 con un 95 % de certeza. Resultados: la prevalencia en los pacientes con varicocele fue del 38,6 %, y en los que no lo presentaban fue de un 26,1%. El test de Chi cuadrado (X2 =6,5; p = 0,01) mostró una asociación significativa entre ambas entidades y la razón de disparidad muestra un ligero incremento del riesgo de padecer de disfunción sexual eréctil en caso de presentar varicocele, (OR=1,7; IC 95%= 1,14-2,78). La media de la concentración sérica de testosterona fue inferior en los pacientes con varicocele (11,8 nmol/L versus 16,1 nmol/L). La prueba t de Student (t=5,6; p = 0,00) mostró una diferencia significativa en ambos grupos con relación a las determinaciones de dicha hormona. Conclusiones: estos hallazgos sugieren que el varicocele puede estar implicado en la aparición de disfunción sexual debido al descenso de los niveles de testosterona.

Tumor contralateral de testículo, debut a los 10 años de evaluación oncológica / Contralateral tumor of the testis, an onset at ten (10) years of oncological assessment: a case report

oven masculino, de la raza negra, de 41 años de edad, que en el año 1999, acude a consulta de urología del Hospital General "Abel Santamaría Cuadrado" por un aumento de volumen del testículo izquierdo, no doloroso con diagnóstico clínico e imaginológico de tumor testicular izquierdo, es ingresado en el servicio de Urología, realizándole el tratamiento quirúrgico (orquiectomia izquierda ) constatándose el resultado biópsico que reporta seminoma clásico, clasificado (T1N1M0), asociando radioterapia y quimioterapia una evolución satisfactoria. El paciente es seguido en las consultas periódicas multidisciplinarías oncourológicas, en el 2009, 10 años después refiere dolor en testículo derecho, aumento de volumen en la porción media e inferior, que se interpreta de inicio como una orquiepididimitis, recibiendo un tratamiento con antibióticos (ciprofloxacina, amoxicilina ) sin respuesta al tratamiento. Los exámenes imageneológicos USG; TAC reportan imágenes nodulares con densidades variables en relación con proceso inflamatorio o tumoral y escasas adenopatías retroperitoniales e inguinales bilaterales la mayor 13mm, por lo que se decide realizar BAFF testicular derecho, comprobándose la existencia de células malignas. Se realiza la orquiectomia derecha, con el diagnóstico histopatológico seminoma testicular clásico T1NOMO-S0 (Etapa Clínica 1A). La evolución post operatoria es satisfactoria, se indica suplemento androgénico y radioterapia 30Gy. Actualmente asintomático.Palabras clave: Seminoma testicular clásico, orquiectomía.ABSTRACTA 41 years-old, black, male patient who in 1999 attended to the urology office at "Abel Santamaria Cuadrado" University Hospital with an increase of volume in the left testis, non-painful having the clinical and imaging diagnose of left testicular tumor, the patient was admitted in the Urology Service to undergo surgical treatment (left orchiectomy), verifying by biopsy, a classic seminoma, which was classified as T1N1MO. Radiotherapy and chemotherapy was indicated showing a satisfactory progress. The patient was followed-up in periodic multidisciplinary, onco-urologic consultations. In 2009, 10 years after, the patient complained of pain in the right testis, increase of volume in the middle-inferior portion of the testis that was interpreted as a process of epididymo-orchitis, starting with antibiotics (ciprofloxacin, amoxicillin),where no-treatment response was observed. Imaging examinations showed nodular imagines with variable densities in relation to an inflammatory or tumoral process and limited retro-perineal and inguinal-bilateral adenopathies <13mm, performing a BAAF in the right testis which verified the existence of malignant cells, a right orchiectomy was carried out, pathologic findings showed a classic testicular seminoma T1NOMO-S0 (Clinical stage 1A). Post operative progress is satisfactory, indicating the treatment of androgenic supplements and y-radiotherapy (30Gy). Currently the patient is asymptomatic.Key words: Classic testicular seminoma, orchiectom

Tumor contralateral de testículo, debut a los 10 años de evaluación oncológica / Contralateral tumor of the testis, an onset at ten (10) years of oncological assessment: a case report

oven masculino, de la raza negra, de 41 años de edad, que en el año 1999, acude a consulta de urología del Hospital General "Abel Santamaría Cuadrado" por un aumento de volumen del testículo izquierdo, no doloroso con diagnóstico clínico e imaginológico de tumor testicular izquierdo, es ingresado en el servicio de Urología, realizándole el tratamiento quirúrgico (orquiectomia izquierda ) constatándose el resultado biópsico que reporta seminoma clásico, clasificado (T1N1M0), asociando radioterapia y quimioterapia una evolución satisfactoria. El paciente es seguido en las consultas periódicas multidisciplinarías oncourológicas, en el 2009, 10 años después refiere dolor en testículo derecho, aumento de volumen en la porción media e inferior, que se interpreta de inicio como una orquiepididimitis, recibiendo un tratamiento con antibióticos (ciprofloxacina, amoxicilina ) sin respuesta al tratamiento. Los exámenes imageneológicos USG; TAC reportan imágenes nodulares con densidades variables en relación con proceso inflamatorio o tumoral y escasas adenopatías retroperitoniales e inguinales bilaterales la mayor 13mm, por lo que se decide realizar BAFF testicular derecho, comprobándose la existencia de células malignas. Se realiza la orquiectomia derecha, con el diagnóstico histopatológico seminoma testicular clásico T1NOMO-S0 (Etapa Clínica 1A). La evolución post operatoria es satisfactoria, se indica suplemento androgénico y radioterapia 30Gy. Actualmente asintomático.Palabras clave: Seminoma testicular clásico, orquiectomía.ABSTRACTA 41 years-old, black, male patient who in 1999 attended to the urology office at "Abel Santamaria Cuadrado" University Hospital with an increase of volume in the left testis, non-painful having the clinical and imaging diagnose of left testicular tumor, the patient was admitted in the Urology Service to undergo surgical treatment (left orchiectomy), verifying by biopsy, a classic seminoma, which was classified as T1N1MO. Radiotherapy and chemotherapy was indicated showing a satisfactory progress. The patient was followed-up in periodic multidisciplinary, onco-urologic consultations. In 2009, 10 years after, the patient complained of pain in the right testis, increase of volume in the middle-inferior portion of the testis that was interpreted as a process of epididymo-orchitis, starting with antibiotics (ciprofloxacin, amoxicillin),where no-treatment response was observed. Imaging examinations showed nodular imagines with variable densities in relation to an inflammatory or tumoral process and limited retro-perineal and inguinal-bilateral adenopathies <13mm, performing a BAAF in the right testis which verified the existence of malignant cells, a right orchiectomy was carried out, pathologic findings showed a classic testicular seminoma T1NOMO-S0 (Clinical stage 1A). Post operative progress is satisfactory, indicating the treatment of androgenic supplements and y-radiotherapy (30Gy). Currently the patient is asymptomatic.Key words: Classic testicular seminoma, orchiectom

Tumor contralateral de testículo, debut a los 10 años de evaluación oncológica Contralateral tumor of the testis, an onset at ten (10) years of oncological assessment

Joven masculino, de la raza negra, de 41 años de edad, que en el año 1999, acude a consulta de urología del Hospital General "Abel Santamaría Cuadrado" por un aumento de volumen del testículo izquierdo, no doloroso con diagnóstico clínico e imaginológico de tumor testicular izquierdo, es ingresado en el servicio de Urología, realizándole el tratamiento quirúrgico (orquiectomia izquierda ) constatándose el resultado biópsico que reporta seminoma clásico, clasificado (T1N1M0), asociando radioterapia y quimioterapia una evolución satisfactoria. El paciente es seguido en las consultas periódicas multidisciplinarías oncourológicas, en el 2009, 10 años después refiere dolor en testículo derecho, aumento de volumen en la porción media e inferior, que se interpreta de inicio como una orquiepididimitis, recibiendo un tratamiento con antibióticos (ciprofloxacina, amoxicilina ) sin respuesta al tratamiento. Los exámenes imageneológicos USG; TAC reportan imágenes nodulares con densidades variables en relación con proceso inflamatorio o tumoral y escasas adenopatías retroperitoniales e inguinales bilaterales la mayor 13mm, por lo que se decide realizar BAFF testicular derecho, comprobándose la existencia de células malignas. Se realiza la orquiectomia derecha, con el diagnóstico histopatológico seminoma testicular clásico T1NOMO-S0 (Etapa Clínica 1A). La evolución post operatoria es satisfactoria, se indica suplemento androgénico y radioterapia 30Gy. Actualmente asintomático.<br>A 41 years-old, black, male patient who in 1999 attended to the urology office at "Abel Santamaria Cuadrado" University Hospital with an increase of volume in the left testis, non-painful having the clinical and imaging diagnose of left testicular tumor, the patient was admitted in the Urology Service to undergo surgical treatment (left orchiectomy), verifying by biopsy, a classic seminoma, which was classified as T1N1MO. Radiotherapy and chemotherapy was indicated showing a satisfactory progress. The patient was followed-up in periodic multidisciplinary, onco-urologic consultations. In 2009, 10 years after, the patient complained of pain in the right testis, increase of volume in the middle-inferior portion of the testis that was interpreted as a process of epididymo-orchitis, starting with antibiotics (ciprofloxacin, amoxicillin),where no-treatment response was observed. Imaging examinations showed nodular imagines with variable densities in relation to an inflammatory or tumoral process and limited retro-perineal and inguinal-bilateral adenopathies <13mm, performing a BAAF in the right testis which verified the existence of malignant cells, a right orchiectomy was carried out, pathologic findings showed a classic testicular seminoma T1NOMO-S0 (Clinical stage 1A). Post operative progress is satisfactory, indicating the treatment of androgenic supplements and y-radiotherapy (30Gy). Currently the patient is asymptomatic