Anti TNF-α therapy might be responsible for an increased incidence of varicocele in patients with ankylosing spondylitis

Turk J Med Sci. 2014;44(2):311-6. doi: 10.3906/sag-1302-136.

Abstract

Aim: To evaluate the effects of anti-tumor necrosis factor-alpha (TNF-α) therapy on the frequency of varicocele in patients with ankylosing spondylitis (AS) using color Doppler ultrasound.

Materials and methods: The patients were divided into 2 groups: patients with AS who were on anti-TNF-α treatment and patients with AS who were not regularly taking any antiinflammatory drugs. Thirty-one healthy volunteers were included as controls.

Results: Left-sided varicocele was determined in 14 patients of Group 1 (44%), 10 patients of Group 2 (33%), and 7 of the controls (23%). There was a statistically significant difference only between Group 1 and controls (P = 0.009). However, right-sided varicocele was determined in 12 patients of Group 1 (38%), 2 patients of Group 2 (6%), and 2 of the controls (6%) (P = 0.01 vs. Group 2, P = 0.005 vs. controls).

Conclusion: The present study shows that patients with AS who were taking anti-TNF-a therapy had an increased prevalence of right- sided and bilateral varicocele compared to patients with AS who were not taking any disease-modifying antirheumatic drugs and the healthy control group.

MeSH terms

  • Adult
  • Antirheumatic Agents / adverse effects*
  • Case-Control Studies
  • Humans
  • Male
  • Spondylitis, Ankylosing / drug therapy*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Ultrasonography, Doppler, Color
  • Valsalva Maneuver
  • Varicocele / diagnostic imaging*
  • Varicocele / etiology
  • Varicocele / pathology

Substances

  • Antirheumatic Agents
  • Tumor Necrosis Factor-alpha