To define the impact of varicoceles (VX) on total testosterone (TT) levels in an aging male population.

This retrospective analysis of a departmental database assessed patients ≥50 years of age, who had 2 testes, and recorded early morning TT levels. Patient demographics, comorbidity profiles, VX laterality, and VX grade were also analyzed.

Data were retrievable for 776 patients. Mean age was 66 ± 12 years. Around 140 (18%) patients had at least 1 VX on examination (VX+). Of these 118 (84%) had unilateral VX while 22 (16%) had bilateral. Mean TT for the VX+ group (336 ng/dL ± 168) was statistically significantly lower than for the VX- group (472 ng/dL ±267) ( P < .01). Those with bilateral VX had lower TT (297 ng/dL) than those with unilateral VX (372 ng/dL) ( P < .05). While 16% of the total VX+ population had TT levels < 300 ng/dl, these rates were 11% and 24% in men with unilateral and bilateral VX ( P < .01). In those with unilateral VX, there was a relationship between VX grade and testosterone deficiency, with the highest likelihood associated with Grade III (r = 0.65, P < .01). There was no association between Grade I and low T levels.

In this population of men older than 50, the presence, laterality, and grade of VX were associated with lower levels of TT.