Improvements in Patient-reported Sexual Function After Microsurgical Varicocelectomy

Urology. 2017 Dec:110:104-109. doi: 10.1016/j.urology.2016.04.044. Epub 2016 May 16.


Objective: To evaluate whether varicocelectomy improves both serum testosterone and sexual function, as assessed by the Male Sexual Health Questionnaire (MSHQ).

Methods: A retrospective chart review of patients who have undergone varicocelectomy and had both pre- and postoperative MSHQ was performed. The MSHQ is a clinically validated questionnaire that assesses erectile function, ejaculatory function, and sexual satisfaction, with higher scores indicating better function. Clinical parameters pre and postvaricocelectomy were compared with paired t test.

Results: Thirty-four patients met study criteria. Seventeen patients (50%) presented for infertility, and the remaining 13 had symptomatic varicocele associated with hypogonadism. Average postsurgical follow-up was 20.6 ± 12.5 months. The majority of men in the study had bilateral varicoceles and left grade III varicoceles. Significant improvements in the total MSHQ score (3.9 ± 8.7, P = .027), the MSHQ erectile function (1.2 ± 2.3, P = .007), and the MSHQ ejaculatory function (1.4 ± 3.1, P = .018) domains were seen. Fifteen (44%) men saw improvement in their erectile function and 18 (53%) saw improvement in ejaculatory function. The improvement in serum testosterone was also significant (136.0 ± 201.3 ng/dL, P = .007).

Conclusion: Microsurgical repair of varicocele not only improves testosterone, but also improves patient-reported erectile and ejaculatory functions. Patients can confidently be counseled that varicocelectomy has the potential to improve sexual function along with serum testosterone.

MeSH terms

  • Adult
  • Ejaculation*
  • Humans
  • Male
  • Microsurgery
  • Orgasm*
  • Patient Reported Outcome Measures
  • Penile Erection*
  • Retrospective Studies
  • Testosterone / blood*
  • Urologic Surgical Procedures, Male / methods
  • Varicocele / surgery*
  • Vascular Surgical Procedures / methods


  • Testosterone