Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USA
We aimed to identify demographic and clinical predictors of varicocele repair in a contemporary cohort of men in the USA. We queried the 2009–2015 MarketScan Database using relevant ICD9, ICD10, and CPT codes to identify all 18–45 year olds with varicoceles. Differences in age, area of residence, cl...
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Format: | Article |
Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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Series: | Asian Journal of Andrology |
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Online Access: | http://www.ajandrology.com/article.asp?issn=1008-682X;year=2019;volume=21;issue=1;spage=45;epage=49;aulast=Guercio |
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author | Cailey Guercio Dattatraya Patil Akanksha Mehta |
author_facet | Cailey Guercio Dattatraya Patil Akanksha Mehta |
author_sort | Cailey Guercio |
collection | DOAJ |
description | We aimed to identify demographic and clinical predictors of varicocele repair in a contemporary cohort of men in the USA. We queried the 2009–2015 MarketScan Database using relevant ICD9, ICD10, and CPT codes to identify all 18–45 year olds with varicoceles. Differences in age, area of residence, clinical characteristics, and medical management between men who did and did not undergo varicocelectomy (open, laparoscopic, or microsurgical) during the study period were compared using unpaired t-tests and Chi-squared tests for continuous and categorical variables, respectively. Multivariable logistic regression analysis was used to evaluate age, semen analyses, and serum hormone assessment as predictors of varicocele repair. SAS version 9.4 was used for all statistical analyses. Significance was set at P < 0.05. Approximately 40% of men with varicoceles underwent repair, primarily through an open approach. Men who underwent repair were more likely to have a diagnosis of male infertility (15.5% vs 7.9%, P < 0.001) and male hypogonadism (3.4% vs 0.9%) and were more likely to complete semen analyses (36.1% vs 12.2%, P < 0.001) and serum testosterone evaluation (42.5% vs 18.8%, P < 0.001). In multivariable regression models, the strongest predictors of varicocele repair were semen analysis (OR = 2.78, 95% CI: 2.56–3.02), age 18–25 years (OR = 2.66, 95% CI: 2.36–2.98), and serum testosterone evaluation (OR = 1.67, 95% CI: 1.51–1.86). Although male infertility remains the most important indication for varicocele repair, male hypogonadism is emerging as an independent predictor of varicocelectomy, which may represent a change in the clinical management of varicoceles in the USA. |
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id | doaj.art-4f3d7da224e54ca28c8766adea0f2c13 |
institution | Directory Open Access Journal |
issn | 1008-682X 1745-7262 |
language | English |
last_indexed | 2024-12-21T01:52:00Z |
publishDate | 2019-01-01 |
publisher | Wolters Kluwer Medknow Publications |
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series | Asian Journal of Andrology |
spelling | doaj.art-4f3d7da224e54ca28c8766adea0f2c132022-12-21T19:19:53ZengWolters Kluwer Medknow PublicationsAsian Journal of Andrology1008-682X1745-72622019-01-01211454910.4103/aja.aja_61_18Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USACailey GuercioDattatraya PatilAkanksha MehtaWe aimed to identify demographic and clinical predictors of varicocele repair in a contemporary cohort of men in the USA. We queried the 2009–2015 MarketScan Database using relevant ICD9, ICD10, and CPT codes to identify all 18–45 year olds with varicoceles. Differences in age, area of residence, clinical characteristics, and medical management between men who did and did not undergo varicocelectomy (open, laparoscopic, or microsurgical) during the study period were compared using unpaired t-tests and Chi-squared tests for continuous and categorical variables, respectively. Multivariable logistic regression analysis was used to evaluate age, semen analyses, and serum hormone assessment as predictors of varicocele repair. SAS version 9.4 was used for all statistical analyses. Significance was set at P < 0.05. Approximately 40% of men with varicoceles underwent repair, primarily through an open approach. Men who underwent repair were more likely to have a diagnosis of male infertility (15.5% vs 7.9%, P < 0.001) and male hypogonadism (3.4% vs 0.9%) and were more likely to complete semen analyses (36.1% vs 12.2%, P < 0.001) and serum testosterone evaluation (42.5% vs 18.8%, P < 0.001). In multivariable regression models, the strongest predictors of varicocele repair were semen analysis (OR = 2.78, 95% CI: 2.56–3.02), age 18–25 years (OR = 2.66, 95% CI: 2.36–2.98), and serum testosterone evaluation (OR = 1.67, 95% CI: 1.51–1.86). Although male infertility remains the most important indication for varicocele repair, male hypogonadism is emerging as an independent predictor of varicocelectomy, which may represent a change in the clinical management of varicoceles in the USA.http://www.ajandrology.com/article.asp?issn=1008-682X;year=2019;volume=21;issue=1;spage=45;epage=49;aulast=Guerciodecision-making; hypogonadism; male infertility; varicocele; varicocelectomy |
spellingShingle | Cailey Guercio Dattatraya Patil Akanksha Mehta Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USA Asian Journal of Andrology decision-making; hypogonadism; male infertility; varicocele; varicocelectomy |
title | Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USA |
title_full | Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USA |
title_fullStr | Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USA |
title_full_unstemmed | Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USA |
title_short | Hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the USA |
title_sort | hypogonadism is independently associated with varicocele repair in a contemporary cohort of men in the usa |
topic | decision-making; hypogonadism; male infertility; varicocele; varicocelectomy |
url | http://www.ajandrology.com/article.asp?issn=1008-682X;year=2019;volume=21;issue=1;spage=45;epage=49;aulast=Guercio |
work_keys_str_mv | AT caileyguercio hypogonadismisindependentlyassociatedwithvaricocelerepairinacontemporarycohortofmenintheusa AT dattatrayapatil hypogonadismisindependentlyassociatedwithvaricocelerepairinacontemporarycohortofmenintheusa AT akankshamehta hypogonadismisindependentlyassociatedwithvaricocelerepairinacontemporarycohortofmenintheusa |