Efficacy of scroto-inguinal microsurgical varicocelectomy in treating male infertility

Phan, Hai Thanh; Nguyen, Thanh Xuan; Nguyen, Du Vinh; Vu, Hoai Anh; Le, Duc Anh; Pham, Nhu Hiep

doi:10.1186/s12301-021-00141-1

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Following the varicocelectomy procedure, there was a statistically significant increase in the mean total sperm count and the percentage of motile sperm at both the three-month and sixmonth postoperative marks compared to the levels prior to the surgery. Phan et al [27] reported that the first instance of a spontaneous pregnancy in a couple was reported two months after the surgery. Overall, 26.7% [23 out of 86] of all couples had achieved a pregnancy by the end of the follow-up period.…”

Section: Diegidio Et Almentioning

confidence: 99%

Comparative Study between Open and Laparoscopic Varicocelectomy in Bilateral Varicocele

Awad-Allah,

Balbola,

Shahin

et al. 2024

International Journal of Medical Arts

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Article informationBackground: Varicoceles are tortuous, abnormally dilated scrotal veins.Although there are variations in recurrence rates, none of the surgical techniques outlined for varicocelectomy have been shown to be superior to the others in their ability to increase fertility. Aim of the work:Comparison between open and laparoscopic varicocelectomy in bilateral varicocele regarding outcome and complications. Patients and Methods: One-hundred patients with bilateral primary varicocele and sperm count below 20 million/c.c., were randomly allocated into either open surgical varicocelectomy via sub inguinal approach, or laparoscopic varicocelectomy. For each patient, operative time, recovery rate and complications were reported. Semen analysis, serum sex hormones [Testosterone, FSH and LH] levels were analyzed preoperatively, 3 and 6 months after surgery. Results: In the laparoscopic group, there was statistically significant lower operative time than the open group [22±8.6 vs. 28±6.2; P=0.03]. Also, the laparoscopic group had significant lower hospital stay [P=0.01] and rapid return to normal activity [P=0.01] than the open group. Regarding complications, four patients in the laparoscopic group developed pneumoscrotum versus none in the open group [P=0.01]; otherwise, the overall complication rate was higher in the open group [P=0.04]. Sperm count and motility were improved in both groups after 3 and 6 months; however, abnormal forms of sperms were improved only in the laparoscopic group [P=0.05]. Conclusion:Laparoscopic varicocelectomy was associated with shorter operative time, hospital stay, and rapid return to normal activity. Furthermore, overall complication rate was less with laparoscopic varicocelectomy except for pneumo-scrotum, which was more frequent with laparoscopic varicocelectomy.

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Section: Diegidio Et Almentioning

confidence: 99%

Comparative Study between Open and Laparoscopic Varicocelectomy in Bilateral Varicocele

Awad-Allah,

Balbola,

Shahin

et al. 2024

International Journal of Medical Arts

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“…[ 1 ] The incidence increases by age due to the disruption in blood flow to the testis and likely to cause of infertility in males. [ 2 3 4 ] Surgery is currently considered the gold standard for varicocele therapy and offers a better prognosis when compared with other treatments. [ 5 ] A study by Baazeem et al .…”

Section: Introductionmentioning

confidence: 99%

A comparison between the efficacy and complication of laparoscopic and microsurgical varicocelectomy: Systematic review and meta-analysis

Warli,

Nabil,

Kadar

et al. 2024

Urology Annals

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Varicocele is the dilatation of the scrotal veins and may affect sperm count and infertility. It is caused by congenital vein insufficiency or absence of venous valve. The main treatment is by surgery, and currently, there are two minimally invasive choices: laparoscopic and microsurgical varicocelectomy. This systematic review aimed to record randomized clinical trials from various sources using all qualified studies up to June 2022. The assessed outcomes were operation time, hydrocele, hospital stay, change in semen parameter, recurrence rate, and pregnancy rate. The essential data extracted were Jadad score, publication year, age, and sample size. This systematic review consisted of 509 and 512 patients in the laparoscopic and microsurgery group, respectively, taken from 12 out of 281 studies. The result of this systematic review was significant difference in operation time between patients from two groups (weighted mean difference [WMD] −21.40, 95% confidence interval [CI]: −28.90–−13.89); length of hospitalization (WMD: 0.38, 95% CI: 0.02–0.74); laparoscopic could significantly increase the risk of hydrocele by 3.30-fold (risk ratio [RR]: 3.30, 95% CI: 1.07–10.12); laparoscopic could significantly increase the recurrence rate by 6.98-fold (RR: 6.98, 95% CI: 3.46–14.08); no significant difference in spontaneous pregnancy between patients in both groups (RR: 0.81, 95% CI: 0.57–1.16); and laparoscopic surgery decreased the occurrence of sperm parameter changes by 40% (RR = 0.40, 95% CI: 0.25–0.62).

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Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

Cannarella

Shah

Hamoda

et al. 2024

World J Mens Health

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Purpose The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and Methods The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129–0.278; p<0.001; I 2 =83.62%, Egger’s p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474–1.706; p<0.001; I 2 =97.86%, Egger’s p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526–2.121; p<0.001; I 2 =97.88%, Egger’s p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318–1.968; p<0.001; I 2 =98.65%, Egger’s p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%–2.153%; p<0.001; I 2 =98.97%, Egger’s p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%–1.759%; p<0.001; l2=97.98%, Egger’s p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%–1.211%; p<0.001; I 2 =97.87%, Egger’s p=0.1864. Conclusions The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele.

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Efficacy of scroto-inguinal microsurgical varicocelectomy in treating male infertility

Cited by 3 publications

References 22 publications

Comparative Study between Open and Laparoscopic Varicocelectomy in Bilateral Varicocele

Comparative Study between Open and Laparoscopic Varicocelectomy in Bilateral Varicocele

A comparison between the efficacy and complication of laparoscopic and microsurgical varicocelectomy: Systematic review and meta-analysis

Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

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