Consensus and Diversity in the Management of Varicocele for Male Infertility : Results of a Global Practice Survey and Comparison with Guidelines and Recommendations
Shah, Rupin (Lilavati Hospital and Research Centre. Department of Urology (Índia))
Agarwal, Ashok (Cleveland Clinic. American Center for Reproductive Medicine)
Kavoussi, Parviz (Austin Fertility & Reproductive Medicine/Westlake IVF, TX)
Rambhatla, Amarnath (Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI)
Saleh, Ramadan (Sohag University (Egipte))
Cannarella, Rossella (Department of Clinical and Experimental Medicine, University of Catania, Catania)
Harraz, Ahmed (Sabah Al Ahmad Urology Center (Kuwait))
Boitrelle, Florence (Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas)
Kuroda, Shinnosuke (Cleveland Clinic. American Center for Reproductive Medicine)
Hamoda, Taha (Minia University, Minia. Department of Urology (Egipte))
Zini, Armand (McGill University (Canadà))
Ko, Edmund (Loma Linda University Health (Estats Units d'Amèrica))
Calik, Gokhan (Department of Urology, Faculty of Medicine, Istanbul Medipol University, Istanbul)
Toprak, Tuncay (Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul)
Kandil, Hussein (Fakih IVF Fertility Center, Abu Dhabi)
Gül, Murat (Department of Urology, Selcuk University School of Medicine, Konya)
Bakırcıoğlu, Mustafa Emre (SENSART Clinic, Istanbul)
Parekh, Neel (Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH)
Russo, Giorgio Ivan (University of Catania (Sicília, Itàlia))
Tadros, Nicholas (Division of Urology, Southern Illinois University School of Medicine, Springfield, IL)
Kadioglu, Ates (Istanbul University (Turquia))
Arafa, Mohamed (Weill Cornell Medical College in Qatar)
Chung, Eric (Princess Alexandra Hospital (Austràlia))
Rajmil, Osvaldo (Fundació Puigvert)
Dimitriadis, Fotios (Department of Urology, Aristotle University of Thessaloniki, Thessaloniki)
Malhotra, Vineet (SCM Clinic and Hospital, New Delhi)
Salvio, Gianmaria (Department of Endocrinology, Polytechnic University of Marche, Ancona)
Henkel, Ralf (Department of Medical Bioscience, University of the Western Cape, Bellville)
Le, Tan V. (Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City)
Sogutdelen, Emrullah (Department of Urology, Bolu Abant Izzet Baysal University, Bolu)
Vij, Sarah (Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH)
Alarbid, Abdullah (Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya)
Gudeloglu, Ahmet (Department of Urology, Faculty of Medicine, Hacettepe University, Ankara)
Tsujimura, Akira (Department of Urology, Juntendo University Urayasu Hospital, Chiba)
Calogero, Aldo E. (Department of Clinical and Experimental Medicine, University of Catania, Catania)
El Meliegy, Amr (Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo)
Crafa, Andrea (Department of Clinical and Experimental Medicine, University of Catania, Catania)
Kalkanli, Arif (Department of Urology, Taksim Education and Research Hospital, Istanbul)
Baser, Aykut (Department of Urology, Faculty of Medicine, Bandırma Onyedi Eylül University, Balıkesir)
Hazir, Berk (Reproductive medicine, Clinical Research Centre, Lund University, Malmö)
Giulioni, Carlo (Polytechnic University of Marche Region (Itàlia))
Cho, Chak-Lam (S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong)
Chee Kong Ho, Christopher (Universiti Teknologi Mara (Malàisia))
Salzano, Ciro (PO San Giovanni Bosco, ASL Napoli 1 Centro, Napoli)
Zylbersztejn, Daniel Suslik (Fleury Group and Hospital Israelita Albert Einstein, São Paulo)
Tien, Dung Mai Ba (Department of Andrology, Binh Dan Hospital, Ho Chi Minh City)
Pescatori, Edoardo (Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna)
Borges, Edson (Fertility Medical Group, São Paulo)
Serefoglu, Ege Can (Department of Urology, Biruni University School of Medicine, Istanbul)
Saïs-Hamza, Emine (Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas)
Huyghe, Eric (Department of Urology and Andrology, University Hospital of Toulouse)
Ceyhan, Erman (Department of Urology, School of Medicine, Baskent University, Konya)
Caroppo, Ettore (Asl Bari, PTA "F Jaia", Reproductive and IVF unit, Andrology Outpatients Clinic, Asl Bari, Conversano (Ba))
Castiglioni, Fabrizio (Andrology Unit, ART Center - San Carlo Clinic, Paderno Dugnano, Milan)
Bahar, Fahmi (Andrology Section, Siloam Sriwijaya Hospital, Palembang)
Gokalp, Fatih (Department of Urology, Hatay Mustafa Kemal University, Antakya)
Lombardo, Francesco (Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, University of Rome "Sapienza", Rome)
Gadda, Franco (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milà, Itàlia))
Duarsa, Gede Wirya Kusuma (Department of Urology, School of Medicine, Udayana University, Denpasar)
Pinggera, Germar-Michael (Department of Urology, Innsbruck Medical University, Innsbruck)
Busetto, Gian Maria (Department of Urology and Organ Transplantation, University of Foggia, Ospedali Riuniti of Foggia, Foggia)
Balercia, Giancarlo (Department of Endocrinology, Polytechnic University of Marche, Ancona)
Cito, Gianmartin (Department of Urology, University of Florence, Florence)
Blecher, Gideon (Department of Urology, The Alfred Hospital, Melbourne)
Franco, Giorgio (Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome)
Liguori, Giovanni (Department of Urology, University of Trieste, Trieste)
Elbardisi, Haitham (Weill Cornell Medical College in Qatar)
Keskin, Hakan (Department of Urology, Faculty of Medicine, Hacettepe University, Ankara)
Lin, Haocheng (Department of Urology, Peking University Third Hospital, Peking University, Beijing)
Taniguchi, Hisanori (Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka)
Park, Hyun Jun (Pusan National University School of Medicine (Corea del Sud))
Ziouziou, Imad (Department of Urology, College of medicine and pharmacy, Ibn Zohr University, Agadir)
de la Rosette, Jean (Istanbul Medipol Mega University Hospital)
Hotaling, James M. (University of Utah School of Medicine)
Ramsay, Jonathan (Department of Andrology, Hammersmith Hospital, Imperial, London)
Corral-Molina, Juan Manuel (Hospital Clínic i Provincial de Barcelona)
Lo, Ka Lun (Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong)
Bocu, Kadir (Silopi State Hospital (Turquia))
Khalafalla, Kareim (Department of Urology, University of Illinois, Chicago, IL)
Bowa, Kasonde (Department of Urology, School of Medicine and Health Sciences, University of Lusaka, Lusaka)
Okada, Keisuke (Department of Urology, Kobe University Graduate School of Medicine, Kobe)
Nagao, Koichi (Department of Urology, Toho University Faculty of Medicine, Tokyo)
Chiba, Koji (Department of Urology, Kobe University Graduate School of Medicine, Kobe)
Hakim, Lukman (Department of Urology, Universitas Airlangga/Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya)
Makarounis, Konstantinos (Locus Medicus (Atenes, Grècia). Department of Urology and Andrology)
Hehemann, Marah (Department of Urology, University of Washington, Seattle, WA)
Peña, Marcelo Rodriguez (Instituto de Ginecología y Fertilidad (IFER), Universidad de Buenos Aires, Buenos Aires)
Falcone, Marco (Città della Salute e della Scienza Hospital (Turin, Itàlia))
Bendayan, Marion (Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas)
Martinez, Marlon (University of Santo Tomas Hospital (Filipines))
Timpano, Massimiliano (Città della Salute e della Scienza Hospital (Turin, Itàlia))
Altan, Mesut (Department of Urology, Haceppete University, Ankara)
Fode, Mikkel (Department of Clinical Medicine, University of Copenhagen, Copenhagen)
Al-Marhoon, Mohammed (Department of Surgery, Urology Division, Sultan Qaboos University, Muscat)
Sadighi Gilani, Mohammad Ali (Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran)
Soebadi, Mohammad Ayodhia (Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya)
Gherabi, Nazim (Andrology Committee of the Algerian Association of Urology)
Sofikitis, Nikolaos (Department of Urology, Ioannina University School of Medicine, Ioannina)
Kahraman, Oğuzhan (Department of Urology, School of Medicine, Baskent University, Konya)
Birowo, Ponco (Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta)
Kothari, Priyank (B.Y.L Nair Ch Hospital (Índia))
Sindhwani, Puneet (Department of Urology, University of Toledo College of Medicine and Life Sciences, Toledo, OH)
Javed, Qaisar (Department of Urology, Al - Ahlia Hospital Abu Dhabi UAE, Abu Dhabi)
Ambar, Rafael F. (Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André)
Kosgi, Raghavender (Department of Urology and Andrology, AIG Hospitals, Hyderabad, Telangana)
Ghayda, Ramy Abou (Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH)
Adriansjah, Ricky (Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Banding)
Condorelli, Rosita Angela (Department of Clinical and Experimental Medicine, University of Catania, Catania)
La Vignera, Sandro (Department of Clinical and Experimental Medicine, University of Catania, Catania)
Micic, Sava (Uromedica Polyclinic (Belgrade, Sèrbia))
Kim, Shannon Hee Kyung (Macquarie School of Medicine, Macquaire University, Sydney, New South Wales)
Fukuhara, Shinichiro (Department of Urology, Graduate School of Medicine, Osaka University, Osaka)
Ahn, Sun Tae (Department of Urology, Korea University College of Medicine, Seoul)
Mostafa, Taymour (Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo)
Ong, Teng Aik (Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur)
Takeshima, Teppei (Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa)
Amano, Toshiyasu (Department of Urology, Nagano Red Cross Hospital, Nagano)
Barrett, Trenton (Perth Urology Clinic, Perth, WA)
Arslan, Umut (Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul)
Karthikeyan, Vilvapathy Senguttuvan (Andrology Unit, Department of Urology, Apollo Hospitals, Greams Road, Chennai)
Atmoko, Widi (AIG Hospitals (Índia))
Yumura, Yasushi (Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa)
Yuan, Yiming (Andrology Center & Urology Department, Peking University First Hospital, Peking University, Beijing)
Kato, Yuki (Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa)
Jezek, Davor (Department for Transfusion Medicine and Transplantation Biology, Reproductive Tissue Bank, University of Zagreb, School of Medicine, University Hospital Zagreb, Zagreb)
Cheng, Bryan Kwun-Chung (Department of Surgery, United Christian Hospital, Hong Kong)
Hatzichristodoulou, Georgios (Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg)
Dy, Jun (Stone and Prostate Treatment Services/Pelvic Floor Center and Anorectal Diseases, St. Luke's Medical Center, Quezon City, Metro Manila)
Ruiz-Castañé, Eduardo (Fundació Puigvert)
El-Sakka, Ahmed (Suez Canal University (Egipte))
Nguyen, Quang (Vietnam National University)
Sarikaya, Selcuk (Department of Urology, Gülhane Research and Training Hospital, University of Health Sciences, Ankara)
Boeri, Luca (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milà, Itàlia))
Tan, Ronny (Mount Elizabeth Hospital)
Moussa, Mohamad A. (Department of Urology, Al Zahraa Hospital, UMC)
El-Assmy, Ahmed (Mansoura University Urology and Nephrology Center, Mansoura)
Alali, Hamed (King Fahad Specialist Hospital, Dammam)
Alhathal, Naif (King Faisal Specialist Hospital and Research Center, Riyadh)
Osman, Yasser (Mansoura University Urology and Nephrology Center, Mansoura)
Perovic, Dragoljub (Urology and Andrology Center, CODRA Hospital, University of Montenegro, Podgorica)
Sajadi, Hesamoddin (B.Y.L Nair Ch Hospital, Mumbai)
Akhavizadegan, Hamed (Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran)
Vučinić, Miroslav (Užice General Hospital, Zlatibor)
Kattan, Said (King Faisal Specialist Hospital and Research Center, Riyadh)
Kattan, Mohamed S. (King Faisal Specialist Hospital and Research Center, Riyadh)
Mogharabian, Nasser (Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud)
Phuoc, Nguyen Ho Vinh (Binh Dan Hospital, Ho Chi Minh City)
Ngoo, Kay Seong (Hospital Angkatan Tentera Tuanku Mizan (Kuala Lumpur, Malàisia))
Alkandari, Mohammad H. (Department of Urology, Mubarak Al-Kabeer Teaching Hospital, Kuwait University, Jabriya)
Alsuhaibani, Shaheed (Imam Abdulrahman Bin Faisal University, Dammam)
Sokolakis, Ioannis (Martha-Maria Hospital Nuremberg, Nuremberg)
Babaei, Mehdi (Shariati Medical Center, Tehran University of Medical Sciences, Tehran)
King, Mak Siu (The Chinese University of Hong Kong, Hong Kong)
Diemer, Thorsten (Pediatric Urology and Andrology, Justus-Liebig-University Giessen (GER), University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen)
Gava, Marcelo M. (Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André)
Henrique, Raphael (Santa Casa de Ribeirão Preto, Ribeirão Preto)
Silva, Rodrigo Spinola e (Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André)
Paul, Gustavo Marquesine (Hospital de Clínicas of the Federal University of Paraná, Curitiba)
Mierzwa, Tiago Cesar (Androlab, Fertility Clinic, Curitiba)
Glina, Sidney (Centro Universitario em Saude do ABC, Santo André)
Siddiqi, Kashif (Cleveland Clinic Abu Dhabi. Department of Urology)
Wu, Han (PKU 3 rd Hospital Reproductive Medicine Center, Beijing)
Wurzacher, Jana (University Hospital Innsbruck (Àustria))
Farkouh, Ala'a (Cleveland Clinic. American Center for Reproductive Medicine)
Son, Hwancheol (SMG-SNU Boramae Medical Center (Seül, Corea del Sud))
Minhas, Suks (Imperial College London)
Lee, Joe (National University Hospital (Singapur))
Magsanoc, Nikko (University of the Philippines College of Medicine (Manila))
Capogrosso, Paolo (University of Insubria (Varese))
Albano, German Jose (University of Santo Tomas Hospital (Manila))
Lewis, Sheena E. M. (Examenlab Ltd., Northern Ireland)
Jayasena, Channa N. (Hammersmith & St. Mary's Hospitals (Londres, Regne Unit))
Alvarez, Juan G. (Centro ANDROGEN (A Coruña))
Teo, Colin (Gleneagles Hospital (Singapur))
Smith, Ryan (University of Virginia School of Medicine (Virginia))
Chua, Jo Ben M. (East Avenue Medical Center (Quezon City, Filipines))
Jensen, Christian Fuglesang S. (Copenhagen University Hospital - Herlev and Gentofte Hospital (Herlev))
Parekattil, Sijo (Avant Concierge Urology & University of Central Florida, Winter Garden, FL)
Finelli, Renata (Cleveland Clinic. American Center for Reproductive Medicine)
Durairajanayagam, Damayanthi (Universiti Teknologi MARA (Sungai Buloh Campus, Selangor))
Karna, Keshab Kumar (Cleveland Clinic. American Center for Reproductive Medicine)
Ahmed, Abdelkareem (Sabah Al Ahmad Urology Center (Kuwait))
Evenson, Don (SCSA Diagnostics, Brookings, SD)
Umemoto, Yukihiro (Nagoya City West Medical Center (Nagoya, Japó))
Puigvert, Ana (Hospital Quirónsalud Barcelona)
Çeker, Gökhan (Zonguldak Bülent Ecevit University Institute of Health Sciences, Zonguldak)
Colpi, Giovanni M (Next Fertility Procrea (Lugano))
Universitat Autònoma de Barcelona

Data:	2022
Resum:	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. 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 Association [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. 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 responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available. This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Consensus ; Disease management ; Male infertility ; Survey ; Varicocele
Publicat a:	The world journal of men's health, Vol. 41 (june 2022) , p. 164-197, ISSN 2287-4690

DOI: 10.5534/wjmh.220048
PMID: 35791302

34 p, 2.0 MB

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