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



Cannarella R1, 2 ; Shah R3 ; Aboalmagd Abdelmeguid Hamoda T4, 5 ; Boitrelle F6, 7 ; Saleh R8 ; Gul M9 ; Rambhatla A10 ; Kavoussi P11 ; Toprak T12 ; Harraz AM13, 14, 15 ; Ko E16 ; Ceker G17 ; Durairajanayagam D18 ; Alkahidi N19 Show All Authors
Authors
  1. Cannarella R1, 2
  2. Shah R3
  3. Aboalmagd Abdelmeguid Hamoda T4, 5
  4. Boitrelle F6, 7
  5. Saleh R8
  6. Gul M9
  7. Rambhatla A10
  8. Kavoussi P11
  9. Toprak T12
  10. Harraz AM13, 14, 15
  11. Ko E16
  12. Ceker G17
  13. Durairajanayagam D18
  14. Alkahidi N19
  15. Kuroda S2, 20
  16. Crafa A1
  17. Henkel R21, 22
  18. Salvio G23
  19. Hazir B24
  20. Darbandi M25, 26
  21. Bendayan M6, 7
  22. Darbandi S25, 26
  23. Falcone M27
  24. Garrido N28
  25. Kosgi R29
  26. Kaiyal RS2
  27. Karna K30
  28. Ho Vinh Phuoc N31, 32
  29. Birowo P33
  30. Colpi GM34
  31. De La Rosette J35
  32. Pinggera GM36
  33. Nguyen Q37, 38
  34. Zini A39
  35. Zohdy W40
  36. Singh R41
  37. Saini P42
  38. Glina S43
  39. Lin H44
  40. Mostafa T40
  41. Rojascruz C45
  42. Arafa M40, 46, 47, 48
  43. Calogero AE1
  44. Dimitriadis F49
  45. Kothari P50
  46. Karthikeyan VS51
  47. Okada K52
  48. Chiba K52
  49. Kadioglu A53
  50. Altay B54
  51. Turunc T55
  52. Zilaitiene B56
  53. Gokalp F57
  54. Adamyan A58
  55. Katz D59, 60, 61
  56. Chung E62
  57. Mierzwa TC43
  58. Zylbersztejn DS63
  59. Paul GM64
  60. Sofikitis N65
  61. Sokolakis I66
  62. Malhotra V67
  63. Brodjonegoro SR68
  64. Adriansjah R69
  65. Tsujimura A70
  66. Amano T71
  67. Balercia G23
  68. Ziouziou I72
  69. Deswanto IA73
  70. Martinez M74
  71. Park HJ75, 76
  72. Bakircioglu ME77
  73. Ceyhan E78
  74. Aydos K79
  75. Ramsay J80
  76. Minhas S81
  77. Hashimi MA82, 83
  78. Ghayda RA84
  79. Tadros N85
  80. Sindhwani P86
  81. Ho CCK87
  82. Rachman RI33
  83. Pena MR88
  84. Motawi A40
  85. Ponnusamy AK89
  86. Dipankar S90
  87. Amir A91
  88. Binsaleh S92
  89. Serefoglu EC93
  90. Banthia R94
  91. Khalafalla K47, 95, 96
  92. Basukarno A97
  93. Bac NH98
  94. Singla K99
  95. Ambar RF43, 100
  96. Makarounis K101
  97. Priyadarshi S102
  98. Kusuma Duarsa GW103
  99. Atmoko W33
  100. Jindal S104
  101. Arianto E105
  102. Akhavizadegan H106
  103. Bardisi HE47, 48
  104. Shoshany O107
  105. Busetto GM108
  106. Moussa M109
  107. Jamali M110
  108. Almarhoon MS111
  109. Ruzaev M112
  110. Farsi HMA4
  111. Mutambirwa S113
  112. Lee DS114
  113. Kulaksiz D115
  114. Cheng YS116
  115. Bouzouita A117
  116. Sarikaya S118
  117. Kandil H119
  118. Tsampoukas G120
  119. Alaa F121
  120. Bowa K122
  121. Savira M33
  122. Mogharabian N123
  123. Le TV31
  124. Harjanggi M124
  125. Anh DT125
  126. Tien Long TQ126
  127. Soebadi MA127
  128. Hakim L128
  129. Tanic M129
  130. Ari UC130
  131. Parikh FR131
  132. Calik G35
  133. Vinod KV132
  134. Dorji G133
  135. Rezano A134, 135
  136. Rajmil O136
  137. Ba Tien DM31
  138. Yuan Y44
  139. Lizarragasalas JF137
  140. Eze B138
  141. Ngoo KS139
  142. Lee J140
  143. Arslan U12
  144. Agarwal A122, 141

Source: World Journal of Men's Health Published:2023


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 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. © 2023 World J Mens Healt. All rights reserved.
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