Selahittin Çayan, Germar-M Pinggera, Widi Atmoko, Taha Hamoda, Rupin Shah, Armand Zini, Eric Chung, Giovanni Maria Colpi, Amarnath Rambhatla, Hiva Alipour, Edmund Y Ko, Nicholas Tadros, Parviz Kavoussi, Manaf Al Hashimi, Taymour Mostafa, Hyun Jun Park, Mikkel Fode, Christopher Chee Kong Ho, Edoardo Pescatori, Ahmed El-Sakka, Mohamed Arafa, Ayman Rashed, Marco Falcone, Gokhan Calik, Aleksei Igorevich Ryzhkov, Tan V Le, Giorgio Ivan Russo, Tuncay Toprak, Fotios Dimitriadis, Shingai Bertrand Angelo Mutambirwa, Muhammad Ujudud Musa, Iman Shamohammadi, Hussein Kandil, Murat Gül, Haitham Elbardisi, Ahmad Tarek Motawi, Sava Micic, Murat Dursun, Taras Shatylko, Coskun Kaya, Ryan Patrick Smith, Nasser Mogharabian, Kareim Khalafalla, Mustafa Kadihasanoglu, Raghavender Kosgi, Osvaldo Rajmil, Yassir Jassim Mohammed, Ashok Agarwal
{"title":"Global Andrology Forum (GAF) Clinical Guidelines on the Management of Infertile Men with Varicocele.","authors":"Selahittin Çayan, Germar-M Pinggera, Widi Atmoko, Taha Hamoda, Rupin Shah, Armand Zini, Eric Chung, Giovanni Maria Colpi, Amarnath Rambhatla, Hiva Alipour, Edmund Y Ko, Nicholas Tadros, Parviz Kavoussi, Manaf Al Hashimi, Taymour Mostafa, Hyun Jun Park, Mikkel Fode, Christopher Chee Kong Ho, Edoardo Pescatori, Ahmed El-Sakka, Mohamed Arafa, Ayman Rashed, Marco Falcone, Gokhan Calik, Aleksei Igorevich Ryzhkov, Tan V Le, Giorgio Ivan Russo, Tuncay Toprak, Fotios Dimitriadis, Shingai Bertrand Angelo Mutambirwa, Muhammad Ujudud Musa, Iman Shamohammadi, Hussein Kandil, Murat Gül, Haitham Elbardisi, Ahmad Tarek Motawi, Sava Micic, Murat Dursun, Taras Shatylko, Coskun Kaya, Ryan Patrick Smith, Nasser Mogharabian, Kareim Khalafalla, Mustafa Kadihasanoglu, Raghavender Kosgi, Osvaldo Rajmil, Yassir Jassim Mohammed, Ashok Agarwal","doi":"10.5534/wjmh.250004","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Varicocele is among the most common reversible causes of male infertility. Although varicocele is prevalent and there is a growing body of literature on the subject, there are still numerous debates surrounding the matter. This study presents Global Andrology Forum (GAF) clinical guidelines on the management of infertile men with varicocele.</p><p><strong>Materials and methods: </strong>A team of clinicians and reproductive experts reviewed contemporary evidence on all aspects of varicocele, including systematic reviews, meta-analyses, and the results of the GAF global survey of practices. They then formulated expert statements and recommendations, subject to a modified Delphi process until a consensus was reached. The final statements and recommendations were rated using the GRADE system.</p><p><strong>Results: </strong>A total of 31 statements and recommendations on the evaluation and management of varicocele were introduced and scored by 24 experts. All experts agreed with the final statements. Varicocele is a significant contributor to male infertility. Its diagnosis is based mainly on physical examination, although imaging can be used in certain cases. Clinical varicocele associated with abnormal sperm parameters is the primary unanimous indication of varicocele repair. However, other indications can still be considered, and recommendations for a tailored approach to controversial situations have been presented. There is inadequate evidence on the use of medical therapy for varicocele.</p><p><strong>Conclusions: </strong>These clinical guidelines on the management of infertile men with varicocele, based on the GAF surveys, systematic reviews, and meta-analyses, point out the pivotal importance of varicocele in modern Andrology. Continued research is crucial to improving diagnostic accuracy and treatment outcomes, ultimately enhancing reproductive health for men with varicocele. Therefore, the current guidelines allow clinicians to develop effective management strategies for a common issue and address practical questions where evidence is lacking.</p>","PeriodicalId":54261,"journal":{"name":"World Journal of Mens Health","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Mens Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5534/wjmh.250004","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANDROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Varicocele is among the most common reversible causes of male infertility. Although varicocele is prevalent and there is a growing body of literature on the subject, there are still numerous debates surrounding the matter. This study presents Global Andrology Forum (GAF) clinical guidelines on the management of infertile men with varicocele.
Materials and methods: A team of clinicians and reproductive experts reviewed contemporary evidence on all aspects of varicocele, including systematic reviews, meta-analyses, and the results of the GAF global survey of practices. They then formulated expert statements and recommendations, subject to a modified Delphi process until a consensus was reached. The final statements and recommendations were rated using the GRADE system.
Results: A total of 31 statements and recommendations on the evaluation and management of varicocele were introduced and scored by 24 experts. All experts agreed with the final statements. Varicocele is a significant contributor to male infertility. Its diagnosis is based mainly on physical examination, although imaging can be used in certain cases. Clinical varicocele associated with abnormal sperm parameters is the primary unanimous indication of varicocele repair. However, other indications can still be considered, and recommendations for a tailored approach to controversial situations have been presented. There is inadequate evidence on the use of medical therapy for varicocele.
Conclusions: These clinical guidelines on the management of infertile men with varicocele, based on the GAF surveys, systematic reviews, and meta-analyses, point out the pivotal importance of varicocele in modern Andrology. Continued research is crucial to improving diagnostic accuracy and treatment outcomes, ultimately enhancing reproductive health for men with varicocele. Therefore, the current guidelines allow clinicians to develop effective management strategies for a common issue and address practical questions where evidence is lacking.
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