The effects of microsurgical varicocelectomy performed for infertility on premature ejaculation

Purpose: To investigate the effects of varicocelectomy on premature ejaculation (PE) in patients with varicocele and infertility.

Methods: A total of 82 sexually active patients aged 18 years or over who had undergone microscopic subinguinal varicocelectomy with a clinical diagnosis of varicocele in 14 urology clinics between October 2021 and March 2023 with primary infertility were evaluated prospectively Patients were evaluated using the Turkish validated form of the 'Premature Ejaculation Diagnostic Tool' (PEDT) scale. A PEDT score of 11 or above was taken to indicate the presence of PE. Turkish validated forms of PEDT and International Index of Erectile Function-5 (IIEF-5) were completed in all patients pre-operatively and at 3 and 6 months post-operatively. Intravaginal ejaculatory latency time (IELT) and serum testosterone measurements were also recorded.

Results: Left varicocelectomy was performed in 70.7% and bilateral varicocelectomy in 29.3% of the participants. A significant difference was found between pre- and post-operative PEDT scores (× 2 (2) = 130.1, p < 0.001). A significant difference was observed between pre- and post-operative IELT time (× 2 (2) = 143.2, p < 0.001). IIEF-5 scores differed before and after surgery (× 2 (2) = 59.5, p < 0.001). A difference was found between the testosterone levels measured before and after surgery (× 2 (2) = 40.9, p < 0.001). No statistically significant difference was observed between the third- and sixth-month testosterone values (p = 0.183). Testosterone levels (p = 0.001) and IELT scores (p < 0.001) were significantly higher, while PEDT scores (p < 0.001) were significantly lower in the bilateral varicocelectomy group at the sixth post-operative month.

Conclusion: In light of our findings, it is recommended that infertile patients with varicocele be informed of the positive effects of varicocelectomy on PE.