Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

被引：3

作者：

Cannarella, Rossella ^{[1
,2
]}

Shah, Rupin ^{[3
]}

Hamoda, Taha Abo-Almagd Abdel-Meguid ^{[4
,5
]}

Boitrelle, Florence ^{[6
,7
]}

Saleh, Ramadan ^{[8
]}

Gul, Murat ^{[9
]}

Rambhatla, Amarnath ^{[10
]}

Kavoussi, Parviz ^{[11
]}

Toprak, Tuncay ^{[12
]}

Harnaz, Ahmed M. ^{[13
,14
,15
]}

Ko, Edmund ^{[16
]}

Ceker, Goekhan ^{[17
]}

Durairajanayagam, Damayanthi ^{[18
]}

Alkahidi, Noora ^{[19
]}

Kuroda, Shinnosuke ^{[2
,20
]}

Crafa, Andrea ^{[1
]}

Henkel, Ralf ^{[21
,22
]}

Salvio, Gianmaria ^{[23
]}

Hazir, Berk ^{[24
]}

Darbandi, Mahsa ^{[25
,26
]}

Bendayan, Marion ^{[6
,7
]}

Darbandi, Sara ^{[25
,26
]}

Falcone, Marco ^{[27
]}

Garrido, Nicolas ^{[28
]}

Kosgi, Raghavender ^{[29
]}

Kaiyal, Raneen Sawaid ^{[2
]}

Karna, Keshab ^{[30
]}

Phuoc, Nguyen Ho Vinh ^{[31
,32
]}

Birowo, Ponco ^{[33
]}

Colpi, Giovanni M. ^{[34
]}

de la Rosette, Jean ^{[35
]}

Pinggera, Germar-Michael ^{[36
]}

Nguyen, Quang ^{[37
,38
]}

Zini, Armand ^{[39
]}

Zohdy, Wael ^{[40
]}

Singh, Rajender ^{[41
]}

Saini, Pallavi ^{[42
]}

Glina, Sidney ^{[43
]}

Lin, Haocheng ^{[44
]}

Mostafa, Taymour ^{[40
]}

Rojas-Cruz, Cesar ^{[45
]}

Arafa, Mohame ^{[40
,46
,47
,48
]}

Calogero, Aldo E. ^{[1
]}

Dimitriadis, Fotios ^{[49
]}

Kothari, Priyank ^{[50
]}

Karthikeyan, Vilvapathy Senguttuvan ^{[51
]}

Okada, Keisuke ^{[52
]}

Chiba, Koji ^{[52
]}

Kadioglu, Ates ^{[53
]}

Altay, Baris ^{[54
]}

机构：

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

[2] Cleveland Clin Fdn, Glickman Urol & Kidney Inst, 9500 Euclid Ave, Cleveland, OH 44195 USA

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

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

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

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

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

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

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

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

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

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

[13] Mansoura Univ, Urol & Nephrol Ctr, Mansoura, Egypt

[14] Farwaniya Hosp, Dept Surg, Urol Unit, Farwaniya, Kuwait

[15] Sabah AI Ahmad Urol Ctr, Dept Urol, Kuwait, Kuwait

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

[17] Basaksehir Cam & Sakura City Hosp, Dept Urol, Istanbul, Turkiye

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

[19] Trinity Hlth Mercy Hlth, Dept Internal Med, Muskegon, MI USA

[20] Yokohama City Univ, Med Ctr, Reprod Ctr, Dept Urol, Yokohama, Kanagawa, Japan

[21] Imperial Coll London, Dept Metab Digest & Reprod, London, England

[22] Univ Western Cape, Dept Med Biosci, Bellville, South Africa

[23] Polytech Univ Med, Dept Endocrinol, Ancona, Italy

[24] Lund Univ, Reprod Med, Clin Res Ctr, Malmo, Sweden

[25] Hope Generat Fdn, Fetal Hlth Res Ctr, Tehran, Iran

[26] Hope Generat Fdn, Gene Therapy & Regenerat Med Res Ctr, Tehran, Iran

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

[28] IVI Fdn, Inst Invest Sanitaria La Fe IIS La Fe, IVIRMA Global Res Alliance, Valencia, Spain

[29] AIG Hosp, Dept Urol Androl & Renal Transplant, Hyderabad, Telangana, India

[30] Univ Massachusetts, Sch Med, Dept Mol Cell & Canc Biol, Worcester, MA USA

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

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

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

[34] Next Fertil Procrea, Androl & IVF Ctr, Lugano, Switzerland

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

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

[37] Viet Duc Univ Hosp, Ctr Androl & Sexual Med, Hanoi, Vietnam

[38] Vietnam Natl Univ, Univ Med & Pharm, Dept Urol Androl & Sexual Med, Hanoi, Vietnam

[39] McGill Univ, Dept Surg, Div Urol, Montreal, PQ, Canada

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

[41] Cent Drug Res Inst, Male Reprod Hlth Res Lab, Lucknow, Uttar Pradesh, India

[42] Cent Drug Res Inst, Div Endocrinol, Lucknow, Uttar Pradesh, India

[43] Ctr Univ FMABC, Div Urol, Santo Andre, SP, Brazil

[44] Peking Univ, Peking Univ Third Hosp, Dept Urol, Beijing, Peoples R China

[45] Univ Hosp Rostock, Dept Urol, Rostock, Germany

[46] Cleveland Clin, Amer Ctr Reprod Med, Cleveland, OH 44106 USA

[47] Hamad Med Corp, Dept Urol, Doha, Qatar

[48] Weill Cornell Med Qatar, Dept Urol, Doha, Qatar

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

[50] BL Nair Ch Hosp, Topiwala Natl Med Coll, Dept Urol, Mumbai, Maharashtra, India

来源：

WORLD JOURNAL OF MENS HEALTH | 2024年 / 42卷 / 01期

关键词：

Controlled before-after studies; Infertility; male; Meta-analysis; Varicocele; SPERM DNA FRAGMENTATION; SUBINGUINAL MICROSURGICAL VARICOCELECTOMY; PERCUTANEOUS RETROGRADE SCLEROTHERAPY; TRANSCATHETER FOAM SCLEROTHERAPY; SUBCLINICAL RIGHT VARICOCELE; COLOR DOPPLER ULTRASOUND; INHIBIN-B LEVELS; INFERTILE MEN; SUBFERTILE MEN; SEMINAL PLASMA;

D O I：

10.5534/wjmh.230034

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: The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and Methods: The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results: Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were includ-ed in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129-0.278; p<0.001; I2=83.62%, Egger's p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474-1.706; p<0.001; I2=97.86%, Egger's p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526-2.121; p<0.001; I2=97.88%, Egger's p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318-1.968; p<0.001; I2=98.65%, Egger's p=0.0003; progressive sperm motil-ity: SMD 1.845, 95% CI: 1.537%-2.153%; p<0.001; I2=98.97%, Egger's p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%-1.759%; p<0.001; l2=97.98%, Egger's p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%-1.211%; p<0.001; I2=97.87%, Egger's p=0.1864. Conclusions: The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele.

引用

页码：92 / 132

页数：41

共 381 条

[51] Studies on varicocele III: Ultrastructural sperm evaluation and 18, X and Y aneuploidies [J].