Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data
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Cannarella, Rossella | Shah, Rupin | Hamoda, Taha Abo-Almagd Abdel-Meguid | Boitrelle, Florence | Saleh, Ramadan | Gul, Murat | Rambhatla, Amarnath | Kavoussi, Parviz | Toprak, Tuncay | Harraz, Ahmed, M | Ko, Edmund | Çeker, Gökhan | Durairajanayagam, Damayanthi | Alkahidi, Noora | Kuroda, Shinnosuke | Crafa, Andrea | Henkel, Ralf | Salvio, Gianmaria | Hazir, Berk | Darbandi, Mahsa | Bendayan, Marion | Darbandi, Sara | Falcone, Marco | Garrido, Nicolas | Kosgi, Raghavender | Sawaid Kaiyal, Raneen, Sawaid | Karna, Keshab | Phuoc, Nguyen, Ho Vinh | Birowo, Ponco | Colpi, Giovanni, M | de la Rosette, Jean | Pinggera, Germar-Michael | Nguyen, Quang | Zini, Armand | Zohdy, Wael | Singh, Rajender | Saini, Pallavi | Glina, Sidney | Lin, Haocheng | Mostafa, Taymour | Rojas-Cruz, Cesar | Arafa, Mohamed | Calogero, Aldo, E | Dimitriadis, Fotios | Kothari, Priyank | Karthikeyan, Vilvapathy, Senguttuvan | Okada, Keisuke | Chiba, Koji | Kadıoglu, Ates | Altay, Baris | Turunc, Tahsin | Zilaitiene, Birute | Gokalp, Fatih | Adamyan, Aram | Katz, Darren | Chung, Eric | Mierzwa, Tiago, Cesar | Zylbersztejn, Daniel, Suslik | Paul, Gustavo, Marquesine | Sofikitis, Nikolaos | Sokolakis, Ioannis | Malhotra, Vineet | Brodjonegoro, Sakti, Ronggowardhana | Adriansjah, Ricky | Tsujimura, Akira | Amano, Toshiyasu | Balercia, Giancarlo | Ziouziou, Imad | Deswanto, Isaac, Ardianson | Martinez, Marlon | Park, Hyun, Jun | Bakırcıoglu, Mustafa, Emre | Ceyhan, Erman | Aydos, Kaan | Ramsay, Jonathan | Minhas, Suks | Hashimi, Manaf, Al | Ghayda, Ramy, Abou | Tadros, Nicholas | Sindhwani, Puneet | Ho, Christopher, C K | Rachman, Rinaldo, Indra | Rodriguez Pena, Marcelo | Motawi, Ahmad | Ponnusamy, Arun, Karthik | Dipankar, Satish | Amir, Azwar | Binsaleh, Saleh | Serefoglu, Ege, Can | Banthia, Ravi | Khalafalla, Kareim | Basukarno, Ari | Bac, Nguyen, Hoai | Singla, Karun | Ambar, Rafael, F | Makarounis, Konstantinos | Priyadarshi, Shivam | Duarsa, Gede, Wirya Kusuma | Atmoko, Widi | Jindal, Sunil | Arianto, Eko | Akhavizadegan, Hamed | El Bardisi, Haitham | Shoshany, Ohad | Busetto, Gian, Maria | Moussa, Mohamad | Jamali, Mounir | Al-Marhoon, Mohamed, S | Ruzaev, Mikhail | Farsi, Hasan, M A | Mutambirwa, Shingai | Lee, Dong, Sup | Kulaksiz, Deniz | Cheng, Yu-Sheng | Bouzouita, Abderrazak | Sarikaya, Selcuk | Kandil, Hussein | Tsampoukas, Georgios | Farkouh, Ala’a | Bowa, Kasonde | Savira, Missy | Mogharabian, Nasser | Le, Tan, V | Harjanggi, Maruto | Anh, Dang, Tuan | Long, Tran, Quang Tien | Soebadi, Mohammad, Ayodhia | Hakim, Lukman | Tanic, Marko | Ari, Umut, Cagin | Parikh, Firuza, R | Calik, Gokhan | Kv, Vinod | Dorji, Gyem | Rezano, Andri | Rajmil, Osvaldo | Tien, Dung, Mai Ba | Yuan, Yiming | Lizarraga-Salas, Juan, Francisco | Eze, Balantine | Ngoo, Kay, Seong | Lee, Joe | Arslan, Umut | Agarwal, Ashok
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CCSD ; Korean Society for Sexual Medicine and Andrology -
International audience.
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 included 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 motility: 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.
