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.
Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data / 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; 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; Al Hashimi, Manaf; 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. - In: THE WORLD JOURNAL OF MEN'S HEALTH. - ISSN 2287-4208. - 41:(2023). [10.5534/wjmh.230034]
Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data
Salvio, Gianmaria;Nguyen, Quang;Balercia, Giancarlo;
2023-01-01
Abstract
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
