Relationship between testicular volume and varicocele in patients with infertility

OBJECTIVES We evaluated the relationship between varicocele and testicular volume determined by ultrasonography in infertile men. METHODS This study included 432 age-matched infertile men, 17 fertile men without scrotal abnormalities, and 20 fertile men with left clinical varicocele. The percentage testicular volume difference (%) between the right and left testicles was calculated as (right testicular volume - left testicular volume) x 100/right testicular volume. RESULTS Of 432 infertile men, 91 had a left clinical varicocele, 32 had left clinical and right subclinical varicoceles, 9 had bilateral clinical varicoceles, 51 had a left subclinical varicocele, 22 had bilateral subclinical varicoceles, 8 had a right subclinical varicocele, and 219 had no varicocele. The relative decrement in left testicular volume compared with right testicular volume was not restricted to patients with varicocele. The presence of right subclinical varicocele did not influence absolute or percentage testicular volume differences in patients with left clinical or subclinical varicocele. Fertile patients with left clinical varicocele had larger absolute and percentage testicular volume differences than patients with infertility and fertile patients without scrotal abnormalities. However, infertile patients with left clinical varicocele, irrespective of the presence of right subclinical varicocele, had larger absolute and percentage testicular volume differences than infertile patients without varicocele, and more frequently had 15% to 30% testicular volume differences than those without varicocele. CONCLUSIONS Left clinical testicular varicocele is associated with relative ipsilateral testicular hypotrophy in infertile patients. However, a subclinical varicocele was not important in determining differences between right and left testicular volumes.