Testicular intrasecretory function and gonad-hypophyseal regulation were studied in 28 patients with the left-sided varicocele whose age varied from 11 to 36 years. Radioimmunoassay was used for the assessment of testosterone, estradiol, progesterone, follicle-stimulating (FS) and luteinizing (L) hormones and prolactin levels in the blood samples from femoral and internal testicular veins taken during endovascularization of varicocele. With regard to the age and manifestations of the secondary sexual signs the patients were divided into three groups. The first group (11-12-year-old) enrolled the patients with normal age-related levels of FS and L hormones in the presence of hyperprolactinemia. The positive testiculoperipheral gradient was revealed in 3 cases for estradiol and in 2 patients for testosterone and progesterone. The peripheral blood testosterone was normal in all the patients whereas estradiol and progesterone were decreased in 2 and 4 cases, respectively. All the patients of the second group (13-15-year-old) demonstrated an increase in testicular blood testosterone and estradiol as compared to their levels in the peripheral blood (1.46-1.8-fold and 1.3-7.1-fold, respectively). In 6 patients, this ratio was 1.65-2.33-fold higher. The levels of FS and L hormones were normal. In all cases hyperprolactinemia was observed. The third group (16-36-year-old) patients demonstrated a 1.4-3.1-fold gradient of testosterone in the testicular blood versus its levels in the peripheral blood. The authors defined 1.1-239-fold (mean, 8.95) estradiol gradients and 0-979-fold (mean, 2.5) progesterone gradients. In all cases but one, the levels of FS and L hormones were equal to the control.(ABSTRACT TRUNCATED AT 250 WORDS)
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