Varicocele Is Associated with Erectile Dysfunction: A Population-Based Case-Control Study


Herng-Ching Lin, PhD, School of Health Care Administration, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St., Taipei 110, Taiwan. Tel: 886-2-2736-1661 ext. 3613; Fax: 886-2-2378-9788; E-mail:


Introduction.  While many studies have been conducted investigating the efficacy of varicocele treatment on fertility, the literature is comparatively sparse concerning the association between varicocele, varicocelectomy, and erectile dysfunction (ED).

Aim.  This study aimed to estimate the associations between varicocele, varicocelectomy, and ED using a population-based dataset.

Methods.  This study used data from the Longitudinal Health Insurance Database 2000 in Taiwan. A total of 32,856 cases and 98,568 randomly selected controls were included in this study. Conditional logistic regression analyses were used to examine associations between ED and having been previously diagnosed with varicocele or having underwent a varicocelectomy.

Main Outcome Measure.  The odds of prior varicocele or having underwent a varicocelectomy between cases and controls.

Results.  Of the sampled patients, the prevalence of prior varicocele was 3.3% and 1.2% for cases and controls, respectively (P < 0.001). Conditional logistic regression analysis suggested that the odds ratio (OR) of being previously diagnosed with varicocele for cases was 3.09 (95% confidence interval [CI] = 2.67–3.49) when compared with controls after adjusting for monthly income, geographic location, hypertension, diabetes, coronary heart disease, hyperlipidemia, hypogonadism, obesity, and alcohol abuse/alcohol dependence syndrome. Furthermore, cases were 1.92 (95% CI = 1.52–2.43) times more likely to have undergone a varicocelectomy than controls. Furthermore, subjects aged between 18 and 29 had the highest ORs for prior varicocele among cases when compared with controls (OR = 5.20; 95% CI = 3.27–8.28).

Conclusion.  This investigation succeeded in identifying an association between both varicocele and ED. We also realized that varicocele patients who underwent a varicocelectomy had lower magnitudes of association with ED than those who did not. Keller JJ, Chen Y-K, and Lin H-C. Varicocele is associated with erectile dysfunction: A population-based case-control study. J Sex Med 2012;9:1762–1769.