Reduction in testicular temperature after varicocelectomy in infertile men.

OBJECTIVES To study the effects of varicocelectomy on testicular temperature. METHODS Testicular skin surface temperature was directly measured with an electronic thermometer calibrated to 0.01 degree C in 119 men before and after microsurgical varicocelectomy and in 45 control patients without varicocele. RESULTS Testicular temperatures in men with varicocele were elevated preoperatively (right side [R]: 34.00 +/- 0.91 degrees C/left side [L]: 34.37 +/- 0.87 degrees C unilateral; R: 34.07 +/- 0.83 degrees C/L: 34.34 +/- 0.85 degrees C bilateral) relative to control patients (R: 33.04 +/- 2.47 degrees C/L: 32.86 +/- 2.52 degrees C) (P < 0.01). Postoperative temperatures were unchanged in the control patients. Testicular temperatures decreased after both bilateral and unilateral varicocelectomy (R: 33.03 +/- 0.85 degrees C/L: 32.84 +/- 1.0 degrees C unilateral; R: 33.27 +/- 1.0 degrees C/L: 33.54 +/- 1.2 degrees C bilateral) to levels nearly identical to those of control patients (P < 0.001). CONCLUSIONS Testicular temperatures were elevated bilaterally in men with both unilateral and bilateral varicoceles. Both unilateral and bilateral microsurgical varicocelectomy results in a bilateral decrease in testicular temperature. These results support the hypothesis that a defect in testicular thermoregulation contributes to the pathophysiology of varicocele and demonstrate, for the first time in humans, the efficacy of varicocelectomy in restoring normal testicular temperatures.

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