Bilateral is superior to unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele: a prospective randomized controlled study

Abstract

In conclusion, our study indicated that bilateral is superior to unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele, which is associated with greater improvements in sperm concentration, normal sperm morphology and progressive motility and spontaneous pregnancy rate after the surgery.

Bilateral is superior to unilateral varicocelectomy in infertile men with bilateral varicocele: Systematic review and meta‐analysis

“…By reading headlines and abstracts, we screened out 612 unrelated articles. The remaining 41 articles were reviewed for full text, after screening out the not original articles, not population of interest and insufficient data, 11 articles containing six RCT articles (Chen, Chiu, & Chiu, ; Elbendary & Elbadry, ; Grasso et al, ; Scherr & Goldstein, ; Sun et al, ; Zheng et al, ), and five cohort studies (Baazeem et al, ; Fujisawa, Ishikawa, & Takenaka, ; Libman, Jarvi, Lo, & Zini, ; Ogreden et al, ; Pasqualotto et al, ) were finally enrolled in. The flow diagram of selection was reported in Figure .…”

“…Seven studies (Baazeem et al, ; Elbendary & Elbadry, ; Fujisawa et al, ; Libman et al, ; Ogreden et al, ; Sun et al, ; Zheng et al, ) provided spontaneous pregnancy rates data for 645 patients in the bilateral varicocelectomy group and 704 patients in the unilateral varicocelectomy group at endpoints of follow‐up. Results from both the RCTs (OR: 1.79; 95% CI 1.33–2.41; I 2 = 0%; p < .0001) and cohort studies (OR: 2.02; 95% CI 1.46–2.80; I 2 = 0%; p < .0001) showed that bilateral varicocelectomy is better than with unilateral varicocelectomy.…”

“…Ten studies (Baazeem et al, ; Chen et al, ; Elbendary & Elbadry, ; Fujisawa et al, ; Grasso et al, ; Libman et al, ; Ogreden et al, ; Pasqualotto et al, ; Scherr & Goldstein, ; Sun et al, ; Zheng et al, ) provided sperm concentration data of pre‐operative and post‐operative. We compared 728 patients in the bilateral varicocelectomy group and 835 patients in the unilateral varicocelectomy group in the present meta‐analysis (Figure a).…”

“…We reviewed previously published studies on the efficacy of bilateral varicocelectomy. Most researchers believe that bilateral varicocelectomy can bring more benefit than left varicocelectomy for bilateral varicocele (left clinical with right clinical or left clinical with right subclinical) varicocele patients (Baazeem, Boman, Libman, Jarvi, & Zini, ; Elbendary & Elbadry, ; Grasso, Lania, Castelli, Galli, & Rigatti, ; Ogreden et al, ; Scherr & Goldstein, ; Sun et al, ). Conversely, some researchers have suggested that left varicocelectomy is sufficient for patients with bilateral varicocele because the difference in the SPR between unilateral and bilateral varicocele is not significant (Zheng et al, ).…”

Comparison of clinical outcome of bilateral and unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele: A meta-analysis of randomised controlled trials

“…For infertile males with left clinical and right subclinical varicocele, it is worthwhile to explore whether bilateral or unilateral surgical repair should be underwent. However, a few randomised controlled trials (RCTs) showed conflicting results (Elbendary & Elbadry, 2009;Sun et al, 2017).…”