Varicocele: the origin of benign prostatic hypertrophy? Testosterone dosages in the periprostatic plexus

Abstract

Objectives: In 2008, Gat et al. wrote the hypothesis that benign prostatic hypertrophy (BPH) was caused by reflux from high free testosterone containing blood from varicocele. The purpose of this study is to measure testosterone at the prostatic veins in patients operated for large BPH, confirming Gat’s theory.

Material and methods: In 13 patients, operated by Millin technique, the periprostatic plexus was punctured in 45° tilted position in order to the measure total and free testosterone and dihydrotestosterone. Brachial blood was taken simultaneously for similar measurements. Seven patients had a clinical varicocele.

Results: High testosterone levels, in comparison with the brachial blood, were detected in only two patients. Dihydrotestosterone was at least doubled in all cases, demonstrating that the puncture was done in prostatic drainage area.

Conclusion: Gat’s theory, concerning the role of varicocele in the origin of BPH, could not be confirmed in this study. Technical limitations can be responsible for this.

Keywords:

• Benign prostatic hypertrophy
• Testosterone
• Dihydrotestosterone
• Varicocele