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

Authors: ÖMER YILMAZ, YUNUS UGAN, MAHMUT YENER, MEHMET UMUL, MUSTAFA KAYAN, AYKUT RECEP AKTAŞ, ELİF NİSA ÜNLÜ, BÜNYAMİN KISACIK, BUMİN DEĞİRMENCİ, MELTEM ÇETİN

Abstract: To evaluate the effects of anti-tumor necrosis factor-alpha (TNF-\alpha) 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-\alpha 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-\alpha 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.

Keywords: Varicocele, ankylosing spondylitis, color Doppler ultrasound

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