Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele A Systematic Review and Meta-Analysis

被引：15

作者：

Cannarella, Rossella ^{[1
,2
,3
]}

Shah, Rupin ^{[1
,3
,4
]}

Saleh, Ramadan ^{[3
,5
]}

Boitrelle, Florence ^{[3
,6
,7
]}

Hamoda, Taha Abo-Almagd Abdel-Meguid ^{[3
,8
,9
]}

Singh, Rajender ^{[3
,10
]}

Salvio, Gianmaria ^{[3
,11
]}

Toprak, Tuncay ^{[3
,12
]}

Falcone, Marco ^{[3
,13
]}

Gul, Murat ^{[3
,14
]}

Dimitriadis, Fotios ^{[3
,15
]}

Rambhatla, Amarnath ^{[3
,16
]}

Russo, Giorgio I. ^{[3
,17
]}

Ko, Edmund ^{[3
,18
]}

Zini, Armand ^{[3
,19
]}

Kavoussi, Parviz ^{[3
,20
]}

Phuoc, Nguyen Ho Vinh ^{[3
,21
,22
]}

Kandil, Hussein ^{[3
,23
]}

Abou Ghayda, Ramy ^{[3
,24
]}

Birowo, Ponco ^{[3
,25
]}

Gherabi, Nazim ^{[3
,26
]}

Ceyhan, Erman ^{[3
,27
]}

Dong, Jie ^{[3
,28
]}

Malhotra, Vineet ^{[3
,29
]}

Durairajanayagam, Damayanthi ^{[3
,30
]}

Kolbasi, Bircan ^{[3
,31
]}

Bahar, Fahmi ^{[3
,32
]}

Calik, Gokhan ^{[3
,33
]}

Cayan, Selahittin ^{[3
,34
]}

Pinggera, Germar-Michael ^{[3
,35
]}

Calogero, Aldo E. ^{[2
]}

Rajmil, Osvaldo ^{[3
,36
,37
]}

Mostafa, Taymour ^{[3
,38
]}

Atmoko, Widi ^{[3
,25
]}

Haraz, Ahmed M. ^{[3
,39
,40
,41
]}

Le, Tan V. ^{[3
,21
,22
]}

Rosette, Jean de la ^{[3
,42
]}

Hakim, Lukman ^{[3
,43
]}

Pescatori, Edoardo ^{[3
,44
]}

Sergeyev, Oleg ^{[3
,45
,46
]}

Rashed, Ayman ^{[3
,47
]}

Saini, Pallavi ^{[3
,10
]}

Agarwal, Ashok ^{[3
,48
,49
]}

机构：

[1] Cleveland Clin Fdn, Glickman Urol & Kidney Inst, Dept Urol, Cleveland Hts, OH 44195 USA

[2] Univ Catania, Dept Clin & Expt Med, Catania, Italy

[3] Global Androl Forum, Moreland Hills, OH USA

[4] Lilavati Hosp & Res Ctr, Dept Urol, Mumbai, India

[5] Sohag Univ, Fac Med, Dept Dermatol Venereol & Androl, Sohag, Egypt

[6] Poissy Hosp, Reprod Biol, Fertil Preservat, Androl,CECOS, Poissy, France

[7] Paris Saclay Univ, UVSQ, INRAe, BREED,Dept Biol Reprod Epigenet Environm & Dev, Jouy En Josas, France

[8] King Abdulaziz Univ, Dept Urol, Jeddah, Saudi Arabia

[9] Minia Univ, Fac Med, Dept Urol, Al Minya, Egypt

[10] Cent Drug Res Inst, Div Endocrinol, Lucknow, India

[11] Polytech Univ Marche, Dept Endocrinol, Ancona, Italy

[12] Univ Hlth Sci, Fatih Sultan Mehmet Training & Res Hosp, Dept Urol, Istanbul, Turkiye

[13] Univ Turin, Molinette Hosp, Dept Urol, AOU Citta Salute & Sci, Turin, Italy

[14] Selcuk Univ, Sch Med, Dept Urol, Konya, Turkiye

[15] Aristotle Univ Thessaloniki, Sch Med, Dept Urol, Thessaloniki, Greece

[16] Vattikuti Urol Inst, Dept Urol, Henry Ford Hlth Syst, Detroit, MI 48202 USA

[17] Univ Catania, Urol Sect, Catania, Italy

[18] Loma Linda Univ Hlth, Dept Urol, Loma Linda, CA USA

[19] McGill Univ, Dept Surg, Montreal, PQ, Canada

[20] Austin Fertil & Reprod Med Westlake IVF, Dept Reprod Urol, Austin, TX USA

[21] Binh Dan Hosp, Dept Androl, Ho Chi Minh City, Vietnam

[22] Pham Ngoc Thach Univ Med, Dept Androl & Nephro Urol, Ho Chi Minh City, Vietnam

[23] Fakih IVF Fertil Ctr, Abu Dhabi, U Arab Emirates

[24] Case Western Reserve Univ, Univ Hosp, Urol Inst, Cleveland Hts, OH USA

[25] Univ Indonesia, Cipto Mangunkusumo Gen Hosp, Fac Med, Dept Urol, Jakarta, Indonesia

[26] Algiers Univ, Dept Med, Algiers, Algeria

[27] Baskent Univ, Fac Med, Dept Urol, Ankara, Turkiye

[28] Fourth Mil Med Univ, Tangdu Hosp, Reprod Med Ctr, Xian 710032, Shaanxi, Peoples R China

[29] SCM Clin & Hosp, Dept Urol, New Delhi, India

[30] Univ Teknol MARA, Fac Med, Dept Physiol, Sungai Buloh Campus, Selangor, Malaysia

[31] Istanbul Medipol Univ, Sch Med, Dept Histol & Embryol, Istanbul, Turkiye

[32] Siloam Sriwijaya Hosp, Androl Sect, Palembang, Indonesia

[33] Istanbul Medipol Univ, Dept Urol, Istanbul, Turkiye

[34] Mersin Univ, Sch Med, Dept Urol, Mersin, Turkiye

[35] Med Univ Innsbruck, Dept Urol, Innsbruck, Austria

[36] Fundacio Puigvert, Androl Dept, Barcelona, Spain

[37] Univ Autonoma Barcelona, Inst Invest Biomed Sant Pau IIB Sant Pau, Barcelona, Spain

[38] Cairo Univ, Fac Med, Dept Androl Sexol & STIs, Cairo, Egypt

[39] Farwaniya Hosp, Dept Gen Surg, Urol Unit, Farwaniya, Kuwait

[40] Sabah Al Ahmad Urol Ctr, Dept Urol, Kuwait, Kuwait

[41] Mansoura Univ, Urol & Nephrol Ctr, Dept Urol, Mansoura, Egypt

[42] Istanbul Medipol Mega Univ Hosp, Dept Urol, Istanbul, Turkiye

[43] Univ Airlangga, Univ Airlangga Teaching Hosp, Fac Med, Dept Urol, Surabaya, Indonesia

[44] Next Fertil GynePro, Androl & Reprod Med Unit, Bologna, Italy

[45] Lomonosov Moscow State Univ, Belozersky Inst Phys Chem Biol, Moscow, Russia

[46] Res Ctr Med Genet, Lab Genet Reprod Disorders, Moscow, Russia

[47] 6th October Univ, Dept Urol, Tanta, Egypt

[48] Cleveland Clin, Cleveland Hts, OH 44106 USA

[49] Global Androl Forum, 130 West Juniper Lane, Moreland Hills, OH 44022 USA

来源：

WORLD JOURNAL OF MENS HEALTH | 2024年 / 42卷 / 02期

关键词：

Infertility; male; Malondialdehyde; DNA fragmentation; Varicocele; OXIDATIVE STRESS; MICROSURGICAL VARICOCELECTOMY; CHROMATIN CONDENSATION; LIPID-PEROXIDATION; DAMAGE; QUALITY; FERTILITY; IMPACT; PART; PREVALENCE;

D O I：

10.5534/wjmh.230235

中图分类号：

R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

摘要：

Purpose: Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA).Materials and Methods: A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre-and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD).Results: Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD -1.125, 95% confidence interval [CI] -1.410, -0.840; p<0.0001) with high inter-study heterogeneity (I-2=90.965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD -1.014, 95% CI -1.263, -0.765; p<0.0001, and SMD -1.495, 95% CI -2.116, -0.873; p<0.0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD -2.197, 95% CI -3.187, -1.207; p<0.0001), sperm chromatin structure assay (SMD -0.857, 95% CI -1.156, -0.559; p<0.0001) or TUNEL (SMD -1.599, 95% CI -2.478, -0.719; p<0.0001). A significant decrease in seminal MDA levels was observed following VR (SMD -2.450, 95% CI -3.903 to -0.997, p=0.001) with high inter-study heterogeneity (I-2=93.7%).Conclusions: Using pre-and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients.

引用

页码：321 / 337

页数：17