الفهرس 
AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
Varicoceles are the most dominant finding in men evaluated for infertility, present in 35% of men with primary infertility and 70 to 80% of men with secondary infertility.
A varicocele is known as an abnormal tortuous dilatation of internal spermatic veins and pampiniform plexus of the spermatic cord. The benefit of early varicocele diagnosis and treatment originates from evidence that varicocele results in progressive distortion in testicular function, impaired semen parameters and low testosterone levels.
Varicocelectomy will successfully at least lower testicular damage and in a majority of patients lead to improved semen parameter and increased testosterone levels.
The aim of our study is to clarify the effect of varicocele surgery on testosterone levels.
The study was performed at the urology department of the Beni-suef university hospital on thirty men presented with clinical varicocele fulfilling the inclusion criteria with absence of any of the exclusion criteria .
All patients with mean age 30.8±10.4 years and had clinically palpable bilateral or unilateral varicoceles with exclusion of any patient with undescended testis, history of mumps orchitis, hypogonadotrophic hypogonadism, hyperprolactinemia, uncontrolled diabetes or hypertension, chemotherapy, radiotherapy or hepatic diseases.
For all patients general and local examinations were done. Serum level of testosterone, FSH, LH, prolactin and semen analysis were done before and after inguinal varicocele ligation.
All cases have normal testicular size and varicocele was diagnosed by physical examination and color flow Doppler ultra sound examination. Apart from the varicocele, all cases were medically free with no history suggestive of hypogonadotropic hypogonadism or mumps orchitis. None of patients had received testosterone replacement therapy, anti-estrogen or aromatase enzyme inhibitors.
In our study group, total testosterone increased significantly from 430 ±136.2 ng/dL before varicocele ligation to 668.97±162.3 ng/dL post-surgery with increase free testosterone from14.94±9.6 pg/mL berfore surgery to 24.79±10.7 pg/mL after surgery.
There was no significant change in sperm volume, viability, or percent of abnormally formed sperm after surgery.
By conclusion, subinguinal varicocelectomy leads to significant increases in the serum testosterone level, whatever the varicocele grade.