Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations.

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Author(s): Shah R;Shah R; Agarwal A; Agarwal A; Kavoussi P; Kavoussi P; Rambhatla A; Rambhatla A; Saleh R; Saleh R; Cannarella R; Cannarella R; Harraz AM; Harraz AM; Harraz AM; Harraz AM; Boitrelle F; Boitrelle F; Boitrelle F; Kuroda S; Kuroda S; Hamoda TAA; Hamoda TAA; Hamoda TAA; Zini A; Zini A; Ko E; Ko E; Calik G; Calik G; Toprak T; Toprak T; Kandil H; Kandil H; Gül M; Gül M; Bakırcıoğlu ME; Bakırcıoğlu ME; Parekh N; Parekh N; Russo GI; Russo GI; Tadros N; Tadros N; Kadioglu A; Kadioglu A; Arafa M; Arafa M; Arafa M; Arafa M; Chung E; Chung E; Rajmil O; Rajmil O; Dimitriadis F; Dimitriadis F; Malhotra V; Malhotra V; Salvio G; Salvio G; Henkel R; Henkel R; Henkel R; Le TV; Le TV; Le TV; Sogutdelen E; Sogutdelen E; Vij S; Vij S; Alarbid A; Alarbid A; Gudeloglu A; Gudeloglu A; Tsujimura A; Tsujimura A; Calogero AE; Calogero AE; El Meliegy A; El Meliegy A; Crafa A; Crafa A; Kalkanli A; Kalkanli A; Baser A; Baser A; Hazir B; Hazir B; Giulioni C; Giulioni C; Cho CL; Cho CL; Ho CCK; Ho CCK; Salzano C; Salzano C; Zylbersztejn DS; Zylbersztejn DS; Tien DMB; Tien DMB; Pescatori E; Pescatori E; Borges E; Borges E; Serefoglu EC; Serefoglu EC; Saïs-Hamza E; Saïs-Hamza E; Saïs-Hamza E; Huyghe E; Huyghe E; Ceyhan E; Ceyhan E; Caroppo E; Caroppo E; Castiglioni F; Castiglioni F; Bahar F; Bahar F; Gokalp F; Gokalp F; Lombardo F; Lombardo F; Gadda F; Gadda F; Duarsa GWK; Duarsa GWK; Pinggera GM; Pinggera GM; Busetto GM; Busetto GM; Balercia G; Balercia G; Cito G; Cito G; Blecher G; Blecher G; Blecher G; Franco G; Franco G; Liguori G; Liguori G; Elbardisi H; Elbardisi H; Elbardisi H; Keskin H; Keskin H; Lin H; Lin H; Taniguchi H; Taniguchi H; Park HJ; Park HJ; Park HJ; Ziouziou I; Ziouziou I; de la Rosette J; de la Rosette J; Hotaling J; Hotaling J; Ramsay J; Ramsay J; Molina JMC; Molina JMC; Lo KL; Lo KL; Bocu K; Bocu K; Khalafalla K; Khalafalla K; Khalafalla K; Bowa K; Bowa K; Okada K; Okada K; Nagao K; Nagao K; Chiba K; Chiba K; Hakim L; Hakim L; Makarounis K; Makarounis K; Hehemann M; Hehemann M; Rodriguez Peña M; Rodriguez Peña M; Falcone M; Falcone M; Bendayan M; Bendayan M; Bendayan M; Martinez M; Martinez M; Timpano M; Timpano M; Altan M; Altan M; Fode M; Fode M; Fode M; Al-Marhoon MS; Al-Marhoon MS; Sadighi Gilani MA; Sadighi Gilani MA; Soebadi MA; Soebadi MA; Gherabi N; Gherabi N; Sofikitis N; Sofikitis N; Kahraman O; Kahraman O; Birowo P; Birowo P; Kothari P; Kothari P; Sindhwani P; Sindhwani P; Javed Q; Javed Q; Ambar RF; Ambar RF; Ambar RF; Kosgi R; Kosgi R; Ghayda RA; Ghayda RA; Adriansjah R; Adriansjah R; Condorelli RA; Condorelli RA; La Vignera S; La Vignera S; Micic S; Micic S; Kim SHK; Kim SHK; Kim SHK; Fukuhara S; Fukuhara S; Ahn ST; Ahn ST; Mostafa T; Mostafa T; Ong TA; Ong TA; Takeshima T; Takeshima T; Amano T; Amano T; Barrett T; Barrett T; Arslan U; Arslan U; Karthikeyan VS; Karthikeyan VS; Atmoko W; Atmoko W; Yumura Y; Yumura Y; Yuan Y; Yuan Y; Kato Y; Kato Y; Jezek D; Jezek D; Cheng BK; Cheng BK; Hatzichristodoulou G; Hatzichristodoulou G; Dy J; Dy J; Castañé ER; Castañé ER; El-Sakka AI; El-Sakka AI; Nguyen Q; Nguyen Q; Nguyen Q; Sarikaya S; Sarikaya S; Boeri L; Boeri L; Tan R; Tan R; Tan R; Moussa MA; Moussa MA; Moussa MA; El-Assmy A; El-Assmy A; Alali H; Alali H; Alhathal N; Alhathal N; Osman Y; Osman Y; Perovic D; Perovic D; Sajadi H; Sajadi H; Akhavizadegan H; Akhavizadegan H; Vučinić M; Vučinić M; Kattan S; Kattan S; Kattan MS; Kattan MS; Mogharabian N; Mogharabian N; Phuoc NHV; Phuoc NHV; Ngoo KS; Ngoo KS; Alkandari MH; Alkandari MH; Alsuhaibani S; Alsuhaibani S; Sokolakis I; Sokolakis I; Babaei M; Babaei M; King MS; King MS; Diemer T; Diemer T; Gava MM; Gava MM; Gava MM; Henrique R; Henrique R; Silva RSE; Silva RSE; Silva RSE; Paul GM; Paul GM; Mierzwa TC; Mierzwa TC; Glina S; Glina S; Siddiqi K; Siddiqi K; Wu H; Wu H; Wurzacher J; Wurzacher J; Farkouh A; Farkouh A; Son H; Son H; Minhas S; Minhas S; Lee J; Lee J; Magsanoc N; Magsanoc N; Capogrosso P; Capogrosso P; Albano GJ; Albano GJ; Lewis SEM; Lewis SEM; Jayasena CN; Jayasena CN; Jayasena CN; Alvarez JG; Alvarez JG; Teo C; Teo C; Smith RP; Smith RP; Chua JBM; Chua JBM; Jensen CFS; Jensen CFS; Parekattil S; Parekattil S; Finelli R; Finelli R; Durairajanayagam D; Durairajanayagam D; Karna KK; Karna KK; Ahmed A; Ahmed A; Evenson D; Evenson D; Umemoto Y; Umemoto Y; Puigvert A; Puigvert A; Çeker G; Çeker G; Çeker G; Colpi GM; Colpi GM
Source:
The world journal of men's health [World J Mens Health] 2023 Jan; Vol. 41 (1), pp. 164-197. Date of Electronic Publication: 2022 Jun 13.
Publication Type:
Journal Article
Language:
English

Additional Information
- Corporate Authors:
  Global Andrology Forum
- Source:
  Publisher: Korean Society for Sexual Medicine and Andrology Country of Publication: Korea (South) NLM ID: 101596899 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2287-4208 (Print) Linking ISSN: 22874208 NLM ISO Abbreviation: World J Mens Health Subsets: PubMed not MEDLINE
- Publication Information:
  Original Publication: Seoul : Korean Society for Sexual Medicine and Andrology
- Abstract:
  Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility.
  Materials and Methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field.
  Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available.
  Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.
  Competing Interests: The authors have nothing to disclose.
  (Copyright © 2023 Korean Society for Sexual Medicine and Andrology.)
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- Contributed Indexing:
  Keywords: Consensus; Disease management; Male infertility; Survey; Varicocele
- Publication Date:
  Date Created: 20220706 Latest Revision: 20230920
- Publication Date:
  20230920
- Accession Number:
  PMC9826919
- Accession Number:
  10.5534/wjmh.220048
- Accession Number:
  35791302

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Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations.

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