Study Of Relationship Between Varicocele And Benign Prostatic Hyperplasia

Objective:Benign prostatic hyperplasia（BPH）is one of the common diseases in middle-aged and elderly men,which seriously affects the quality of life of patients.Its etiology is not yet fully understood.Studies have shown that varicocele（VC）may lead to the occurrence and development of BPH.This article takes elderly patients with BPH as the research object to explore the correlation between VC and BPH,and provide a theory for the prevention and treatment of benign prostatic hyperplasia.in accordance with.Methods:144 male patients above 50 years old with BPH,who were admitted to the First Affiliated Hospital of Dali University from October 2020 to December 2021,were selected and their following figures were measured and recorded: international prostate symptom score（IPSS）,Body mass index（BMI）,fasting blood glucose,Prostate Specific Antigen,sex hormones : testosterone（T）,estradiol（E2）,follicle stimulating hormone（FSH）,luteinizing hormone（LH）and estradiol/testosterone（E2/T）.The grade of varicocele,prostate volume（PV）and bilateral testicular volume（TV）of each patient were also measured using color Doppler ultrasound.Based on their medical condition,patients were divided into VC group and non-VC group to check if there was any statistical difference in the clinical data between the two groups using independent samples t test.Then patients were tiered in accordance to their VC grade and their clinical data was compared with one-way analysis of variance.Next,patients were separated into different groups according to their affected sides to check if their clinical data was statistically different using one-way analysis of variance.Finally,a correlation analysis of patients’ PV,age and sex hormones was performed by Pearson correlation analysis and Partial correlation analysis.Results:1.Among the total of 144 BPH patients with an average age of 68.25±8.09 old,81 had VC and 63 did not,bringing the incidence to 56%.Left-side VC and both-side VC patients took up 39.6% and 16.7% of the total.The number of patients diagnosed with grade-1,-2 and-3 VC were 20.9%,24.3% and 11.1%,respectively.The VC occurrence rates among 50-59,60-69,70-79,>80 age groups were 45.4%,58.2%,56.4% and62.5%,respectively;2.Patients in VC group showed significantly lower T and bilateral testicular volume（P<0.05）,and higher estradiol-testosterone ratio（E2/T）,PV and IPSS（P<0.05）than the non-VC group;3.The level of T,E2/T,PV,IPSS,and bilateral testicular volume differed noticeably（P<0.05）in patients graded according to their severity.Multiple comparisons showed higher average E2/T,PV and IPSS levels in grade-2 and-3 VC patients（P<0.05）,and lower T and bilateral testicular volume（P<0.05）,than the non-VC group.In addition,grade-3 patients had notably lower left-side testicular volume（P<0.05）than the grade-1 group;4.The levels of T,E2/T,PV,IPSS,and bilateral testicular volume differed noticeably（P<0.05）in patients with different affected sides.Multiple comparisons showed that average E2/T,PV and IPSS in left-side VC and both-side VC groups were largely higher（P<0.05）,and the T and left-side testicular volume were lower（P<0.05）,than the non-VC group.Additionally,both-side VC patients exhibited largely lower T and right-side testicular volume（P<0.05）,and higher E2/T（P<0.05）,than the left-side VC group;5.Pearson analysis showed a positive correlation between PV and age,E2/T;a negative one between PV and T（r=0.440,r=0.358,r=-0.323,P<0.01）.Removing age,PV remained positively correlated with E2/T and negatively correlated with T（r=0.263,r=-0.257,P<0.01）.Conclusions:1.The incidence of VC is high among elderly BPH patients;2.VC（grade-1excluded）is closely linked to lower testicular volume,T,and higher E2/T,suggesting the fact that VC might damage testicles and lead to testicular atrophy,decrease T and increase E2/T;3.PV is negatively correlated with T and positively correlated with age and E2/T;4.VC（grade-1 excluded）is associated with higher PV and IPSS,indicating a relation between VC and BPH that VC might exacerbate BPH in way of disturbing sex hormones or affecting the prostatic-testicular venous communication.