Objective: To evaluate age-related differences in hormonal and semen parameter responses following varicocelectomy in adolescents and adults, and to explore whether early surgical intervention is justified in younger patients.
Materials and Methods: We retrospectively analyzed 82 patients who underwent subinguinal varicocelectomy and had complete pre- and postoperative hormone and semen profiles. Patients were divided into two age-based groups, group 1 (<21 years, n=30) and group 2 (>30 years, n=52). Hormonal parameters included serum FSH, LH, and total testosterone. Semen parameters included sperm concentration, motility, and morphology. Outcomes were assessed 6-12 months postoperatively.
Results: Both groups exhibited significant improvements in semen parameters postoperatively, with no significant differences in the degree of improvement between groups (p>0.05). In contrast, a significant increase in testosterone levels was observed only in group 2 (p=0.017), and this hormonal improvement was significantly greater than in group 1 (p=0.009). FSH levels were higher in group 2 preoperatively (p=0.006) and postoperatively (p=0.002), yet no significant intragroup changes in FSH or LH were detected.
Conclusion: While varicocelectomy improves semen parameters in both adolescents and adults, meaningful hormonal recovery appears to be limited to older patients. These findings suggest that early surgical intervention may not be necessary for all adolescents and highlight the importance of individualized, hormone-informed treatment strategies. Prospective studies with longer follow-up are warranted to guide age-specific clinical decision-making.
Abstract
Objective: To evaluate age-related differences in hormonal and semen parameter responses following varicocelectomy in adolescents and adults, and to explore whether early surgical intervention is justified in younger patients.
Materials and Methods: We retrospectively analyzed 82 patients who underwent subinguinal varicocelectomy and had complete pre- and postoperative hormone and semen profiles. Patients were divided into two age-based groups, group 1 (<21 years, n=30) and group 2 (>30 years, n=52). Hormonal parameters included serum FSH, LH, and total testosterone. Semen parameters included sperm concentration, motility, and morphology. Outcomes were assessed 6-12 months postoperatively.
Results: Both groups exhibited significant improvements in semen parameters postoperatively, with no significant differences in the degree of improvement between groups (p>0.05). In contrast, a significant increase in testosterone levels was observed only in group 2 (p=0.017), and this hormonal improvement was significantly greater than in group 1 (p=0.009). FSH levels were higher in group 2 preoperatively (p=0.006) and postoperatively (p=0.002), yet no significant intragroup changes in FSH or LH were detected.
Conclusion: While varicocelectomy improves semen parameters in both adolescents and adults, meaningful hormonal recovery appears to be limited to older patients. These findings suggest that early surgical intervention may not be necessary for all adolescents and highlight the importance of individualized, hormone-informed treatment strategies. Prospective studies with longer follow-up are warranted to guide age-specific clinical decision-making.