Consensus and diversity in the management of varicocele for male infertility: Results of a global practice survey and comparison with guidelines and recommendations
Yükleniyor...
Dosyalar
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Korean Society for Sexual Medicine and Andrology
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
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 As-sociation [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 re-sponses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identi-fied where no guidelines are available. Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male in-fertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical prac-tice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.
Açıklama
This research was supported by the American Center for Reproductive Medicine, Cleveland Clinic (Project Number: IF100066).
Anahtar Kelimeler
Consensus, Disease Management, Male Infertility, Microsurgical Subinguinal Varicocelectomy, Assisted Reproductive Technology, Impaired Semen Quality
Kaynak
World Journal of Mens Health
WoS Q Değeri
Q1
Scopus Q Değeri
Q1
Cilt
41
Sayı
1
Künye
Shah, R., Agarwal, A., Kavoussi, P., Rambhatla, A., Saleh, R., Cannarella, R., ... & Alsuhaibani, S. (2023). Consensus and diversity in the management of varicocele for male infertility: results of a global practice survey and comparison with guidelines and recommendations. The World Journal of Men's Health, 41(1), 164.
