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Article Dans Une Revue The World Journal of Men's Health Année : 2023

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

Rupin Shah (1) , Ashok Agarwal (2, 3) , Parviz Kavoussi (4) , Amarnath Rambhatla (5) , Ramadan Saleh (6) , Rossella Cannarella (7, 3) , Ahmed Harraz (8) , Florence Boitrelle (9, 10) , Shinnosuke Kuroda (3, 11) , Taha Abo-Almagd Abdel-Meguid Hamoda (12, 13) , Armand Zini (14) , Edmund Ko (15) , Gokhan Calik (16) , Tuncay Toprak (17) , Hussein Kandil (18) , Murat Gül (19) , Mustafa Emre Bakırcıoğlu , Neel Parekh (3) , Giorgio Ivan Russo (7) , Nicholas Tadros (20) , Ates Kadioglu , Mohamed Arafa , Eric Chung , Osvaldo Rajmil , Fotios Dimitriadis , Vineet Malhotra , Gianmaria Salvio , Ralf Henkel , Tan Le , Emrullah Sogutdelen , Sarah Vij , Abdullah Alarbid , Ahmet Gudeloglu , Akira Tsujimura , Aldo Calogero , Amr El Meliegy , Andrea Crafa , Arif Kalkanli , Aykut Baser , Berk Hazir , Carlo Giulioni , Chak-Lam Cho , Christopher C.K. Ho , Ciro Salzano , Daniel Suslik Zylbersztejn , Dung Mai Ba Tien , Edoardo Pescatori , Edson Borges , Ege Can Serefoglu , Emine Saïs-Hamza , Eric Huyghe , Erman Ceyhan , Ettore Caroppo , Fabrizio Castiglioni , Fahmi Bahar , Fatih Gokalp , Francesco Lombardo , Franco Gadda , Gede Wirya Kusuma Duarsa , Germar-Michael Pinggera , Gian Maria Busetto , Giancarlo Balercia , Gianmartin Cito , Gideon Blecher , Giorgio Franco , Giovanni Liguori , Haitham Elbardisi , Hakan Keskin , Haocheng Lin , Hisanori Taniguchi , Hyun Jun Park , Imad Ziouziou , Jean de la Rosette , Jim Hotaling , Jonathan Ramsay , Juan Manuel Corral Molina , Ka Lun Lo , Kadir Bocu , Kareim Khalafalla , Kasonde Bowa , Keisuke Okada , Koichi Nagao , Koji Chiba , Lukman Hakim , Konstantinos Makarounis , Marah Hehemann , Marcelo Rodriguez Peña , Marco Falcone , Marion Bendayan , Marlon Martinez , Massimiliano Timpano , Mesut Altan , Mikkel Fode , Mohamed Al-Marhoon , Mohammad Ali Sadighi Gilani , Mohammad Ayodhia Soebadi , Nazim Gherabi , Nikolaos Sofikitis , Oğuzhan Kahraman , Ponco Birowo , Priyank Kothari , Puneet Sindhwani , Qaisar Javed , Rafael Ambar , Raghavender Kosgi , Ramy Abou Ghayda , Ricky Adriansjah , Rosita Angela Condorelli , Sandro La Vignera , Sava Micic , Shannon Hee Kyung Kim , Shinichiro Fukuhara , Sun Tae Ahn , Taymour Mostafa , Teng Aik Ong , Teppei Takeshima , Toshiyasu Amano , Trenton Barrett , Umut Arslan , Vilvapathy Senguttuvan Karthikeyan , Widi Atmoko , Yasushi Yumura , Yiming Yuan , Yuki Kato , Davor Jezek , Bryan Kwun-Chung Cheng , Georgios Hatzichristodoulou , Jun Dy , Eduard Ruiz Castañé , Ahmed El-Sakka , Quang Nguyen , Selcuk Sarikaya , Luca Boeri , Ronny Tan , Mohamad Moussa , Ahmed El-Assmy , Hamed Alali , Naif Alhathal , Yasser Osman , Dragoljub Perovic , Hesamoddin Sajadi , Hamed Akhavizadegan , Miroslav Vučinić , Said Kattan , Mohamed Kattan , Nasser Mogharabian , Nguyen Ho Vinh Phuoc , Kay Seong Ngoo , Mohammad Alkandari , Shaheed Alsuhaibani , Ioannis Sokolakis , Mehdi Babaei , Mak Siu King , Thorsten Diemer , Marcelo Gava , Raphael Henrique , Rodrigo Spinola E Silva , Gustavo Marquesine Paul , Tiago Cesar Mierzwa , Sidney Glina , Kashif Siddiqi , Han Wu , Jana Wurzacher , Ala’a Farkouh , Hwancheol Son , Suks Minhas , Joe Lee , Nikko Magsanoc , Paolo Capogrosso , German Jose Albano , Sheena Lewis , Channa Jayasena , Juan Alvarez , Colin Teo , Ryan Smith , Jo Ben M. Chua , Christian Fuglesang S. Jensen , Sijo Parekattil , Renata Finelli , Damayanthi Durairajanayagam , Keshab Kumar Karna , Abdelkareem Ahmed , Don Evenson , Yukihiro Umemoto , Ana Puigvert , Gökhan Çeker , Giovanni Colpi
Rupin Shah
Ashok Agarwal
Amarnath Rambhatla
Ramadan Saleh
Ahmed Harraz
Edmund Ko
Gokhan Calik
Hussein Kandil
Mustafa Emre Bakırcıoğlu
Neel Parekh
Ates Kadioglu
Mohamed Arafa
Eric Chung
Osvaldo Rajmil
Fotios Dimitriadis
Vineet Malhotra
Gianmaria Salvio
Ralf Henkel
Tan Le
Emrullah Sogutdelen
Sarah Vij
Abdullah Alarbid
Ahmet Gudeloglu
Akira Tsujimura
Aldo Calogero
Amr El Meliegy
Andrea Crafa
Arif Kalkanli
Aykut Baser
Berk Hazir
Carlo Giulioni
Chak-Lam Cho
Christopher C.K. Ho
Ciro Salzano
Daniel Suslik Zylbersztejn
Dung Mai Ba Tien
Edoardo Pescatori
Edson Borges
Ege Can Serefoglu
Emine Saïs-Hamza
Eric Huyghe
Erman Ceyhan
Ettore Caroppo
Fabrizio Castiglioni
Fahmi Bahar
Fatih Gokalp
Francesco Lombardo
Franco Gadda
Gede Wirya Kusuma Duarsa
Germar-Michael Pinggera
Gian Maria Busetto
Giancarlo Balercia
Gianmartin Cito
Gideon Blecher
Giorgio Franco
Giovanni Liguori
Haitham Elbardisi
Hakan Keskin
Haocheng Lin
Hisanori Taniguchi
Hyun Jun Park
Imad Ziouziou
Jean de la Rosette
Jim Hotaling
Jonathan Ramsay
Juan Manuel Corral Molina
Ka Lun Lo
Kadir Bocu
Kareim Khalafalla
Kasonde Bowa
Keisuke Okada
Koichi Nagao
Koji Chiba
Lukman Hakim
Konstantinos Makarounis
Marah Hehemann
Marcelo Rodriguez Peña
Marco Falcone
Marion Bendayan
Marlon Martinez
Massimiliano Timpano
Mesut Altan
Mikkel Fode
Mohamed Al-Marhoon
Mohammad Ali Sadighi Gilani
Mohammad Ayodhia Soebadi
Nazim Gherabi
Nikolaos Sofikitis
Oğuzhan Kahraman
Ponco Birowo
Priyank Kothari
Puneet Sindhwani
Qaisar Javed
Rafael Ambar
Raghavender Kosgi
Ramy Abou Ghayda
Ricky Adriansjah
Rosita Angela Condorelli
Sandro La Vignera
Sava Micic
Shannon Hee Kyung Kim
Shinichiro Fukuhara
Sun Tae Ahn
Taymour Mostafa
Teng Aik Ong
Teppei Takeshima
Toshiyasu Amano
Trenton Barrett
Umut Arslan
Vilvapathy Senguttuvan Karthikeyan
Widi Atmoko
Yasushi Yumura
Yiming Yuan
Yuki Kato
Davor Jezek
Bryan Kwun-Chung Cheng
Georgios Hatzichristodoulou
Jun Dy
Eduard Ruiz Castañé
Ahmed El-Sakka
Quang Nguyen
Selcuk Sarikaya
Luca Boeri
Ronny Tan
Mohamad Moussa
Ahmed El-Assmy
Hamed Alali
Naif Alhathal
Yasser Osman
Dragoljub Perovic
Hesamoddin Sajadi
Hamed Akhavizadegan
Miroslav Vučinić
Said Kattan
Mohamed Kattan
Nasser Mogharabian
Nguyen Ho Vinh Phuoc
Kay Seong Ngoo
Mohammad Alkandari
Shaheed Alsuhaibani
Ioannis Sokolakis
Mehdi Babaei
Mak Siu King
Thorsten Diemer
Marcelo Gava
Raphael Henrique
Rodrigo Spinola E Silva
Gustavo Marquesine Paul
Tiago Cesar Mierzwa
Sidney Glina
Kashif Siddiqi
Han Wu
Jana Wurzacher
Ala’a Farkouh
Hwancheol Son
Suks Minhas
Joe Lee
Nikko Magsanoc
Paolo Capogrosso
German Jose Albano
Sheena Lewis
Channa Jayasena
Juan Alvarez
Colin Teo
Ryan Smith
Jo Ben M. Chua
Christian Fuglesang S. Jensen
Sijo Parekattil
Renata Finelli
Damayanthi Durairajanayagam
Keshab Kumar Karna
Abdelkareem Ahmed
Don Evenson
Yukihiro Umemoto
Ana Puigvert
Gökhan Çeker
Giovanni Colpi

Résumé

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.

Dates et versions

hal-04347195 , version 1 (15-12-2023)

Identifiants

Citer

Rupin Shah, Ashok Agarwal, Parviz Kavoussi, Amarnath Rambhatla, Ramadan Saleh, et al.. 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, 2023, 41 (1), pp.164-197. ⟨10.5534/wjmh.220048⟩. ⟨hal-04347195⟩
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