MP91-06 VARICOCELES ARE ASSOCIATED WITH INCREASED RISK OF CARDIAC DISEASE AND OTHER COMORBIDITIES: AN ANALYSIS OF U.S. CLAIMS DATA.

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation1 Apr 2016MP91-06 VARICOCELES ARE ASSOCIATED WITH INCREASED RISK OF CARDIAC DISEASE AND OTHER COMORBIDITIES: AN ANALYSIS OF U.S. CLAIMS DATA. Kai B. Dallas, Nancy N. Wang, ShuFeng Li, Laurence C. Baker, and Michael Eisenberg Kai B. DallasKai B. Dallas More articles by this author , Nancy N. WangNancy N. Wang More articles by this author , ShuFeng LiShuFeng Li More articles by this author , Laurence C. BakerLaurence C. Baker More articles by this author , and Michael EisenbergMichael Eisenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2593AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Varicoceles occur in 15% of men, and while most cases are asymptomatic, patients may present with pain, testicular atrophy, and impaired sperm production. Prior? studies have revealed an association between varicocele and testosterone levels. Given that low testosterone levels have been associated with metabolic and vascular diseases, we sought to determine the association between varicocele and incident medical comorbidities. METHODS Men with a history of varicocele were identified from the Truven Health MarketScan® claims database from 2001-2008 using diagnosis (ICD-9) and treatment codes (CPT). Symptomatic men were identified based on the presence of semen/fertility problems, testicular failure, testicular atrophy or testicular pain. These men were compared to men evaluated for infertility or underwent a vasectomy (e.g. presumably fertile men). We focused on metabolic and vascular diseases (i.e. hypertension, diabetes, hyperlipidemia, renal disease, peripheral vascular disease, cerebrovascular disease, and heart disease) that occurred after one year of diagnosis of varicocele. Cox regression analysis was used to compare groups, controlling for age, obesity, smoking, year of evaluation, number of office visits, and follow-up time. RESULTS 4459 men with varicoceles, 21840 men who underwent infertility testing, and 78226 men who underwent vasectomy were identified. Average follow up was 3.1 years. Men with varicocele had a higher incidence of heart disease compared to men who underwent infertility testing (HR 1.22, 95% CI: 1.03-1.45), and utilizing vasectomy (HR 1.32, 95% CI 1.13-1.54). Men with varicocele also had a higher risk of diabetes (HR 1.73, 95% CI: 1.37-2.18) and hyperlipidemia (HR 1.15, 95% CI: 1.03-1.28) as compared to the vasectomy group. Men with symptomatic varicoceles (n=3442) had similar elevations in risk of heart disease, diabetes, and hyperlipidemia as seen in the whole cohort. There was not increased risk in men with asymptomatic varicoceles (n=1017). CONCLUSIONS The current data suggests an elevated risk of developing metabolic/vascular comorbidities (i.e. heart disease, diabetes and hyperlipidemia) in the years following a symptomatic varicocele diagnosis. Given the prevalence of varicoceles in the world, further research is needed to understand the implications of a varicocele to a man’s health. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1155 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kai B. Dallas More articles by this author Nancy N. Wang More articles by this author ShuFeng Li More articles by this author Laurence C. Baker More articles by this author Michael Eisenberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...