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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dc.authoridliguori, giovanni/0000-0003-2431-5296
dc.authoridBusetto, Gian Maria/0000-0002-7291-0316
dc.authoridJenkins, Lawrence C/0000-0003-0125-673X
dc.authoridKahraman, Oguzhan/0000-0003-3691-8617
dc.authoridShah, Rupin/0000-0002-7868-5949
dc.authoridHamoda, Taha/0000-0002-8070-4088
dc.authoridJayasena, Channa/0000-0002-2578-8223
dc.contributor.authorShah, Rupin
dc.contributor.authorAgarwal, Ashok
dc.contributor.authorKavoussi, Parviz
dc.contributor.authorRambhatla, Amarnath
dc.contributor.authorSaleh, Ramadan
dc.contributor.authorCannarella, Rossella
dc.contributor.authorHarraz, Ahmed M.
dc.date.accessioned2024-09-18T20:11:48Z
dc.date.available2024-09-18T20:11:48Z
dc.date.issued2023
dc.departmentHatay Mustafa Kemal Üniversitesien_US
dc.description.abstractPurpose: 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.en_US
dc.description.sponsorshipAmerican Center for Reproductive Medicine, Cleveland Clinic [IF100066]en_US
dc.description.sponsorshipThis research was supported by the American Center for Reproductive Medicine, Cleveland Clinic (Project Number: IF100066).en_US
dc.identifier.doi10.5534/wjmh.220048
dc.identifier.endpage197en_US
dc.identifier.issn2287-4208
dc.identifier.issn2287-4690
dc.identifier.issue1en_US
dc.identifier.pmid35791302en_US
dc.identifier.scopus2-s2.0-85134651253en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage164en_US
dc.identifier.urihttps://doi.org/10.5534/wjmh.220048
dc.identifier.urihttps://hdl.handle.net/20.500.12483/9074
dc.identifier.volume41en_US
dc.identifier.wosWOS:000815049600001en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherKorean Soc Sexual Medicine & Andrologyen_US
dc.relation.ispartofWorld Journal of Mens Healthen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectConsensusen_US
dc.subjectDisease managementen_US
dc.subjectMale infertilityen_US
dc.subjectSurveyen_US
dc.subjectVaricoceleen_US
dc.titleConsensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendationsen_US
dc.typeArticleen_US

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