Scopus
🔓 Açık Erişim YÖKSİS Eşleşti
Effects of Varicocele Repair on Testicular Endocrine Function: A Systematic Review and Meta-Analysis
World Journal of Men S Health · Ekim 2025
YÖKSİS Kayıtları
Effects of Varicocele Repair on Testicular Endocrine Function: A Systematic Review and Meta-Analysis
The World Journal of Men's Health · 2024 SCI-Expanded
DOÇENT MURAT GÜL →
Makale Bilgileri
DergiWorld Journal of Men S Health
Yayın TarihiEkim 2025
Cilt / Sayfa43 · 818-843
Scopus ID2-s2.0-105017871885
Erişim🔓 Açık Erişim
Özet
Purpose: The objective of this manuscript is to assess the effect of varicocele repair (VR) in patients with clinical varicoceles on serum total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and inhibin B serum levels. Materials and Methods: The study was performed in compliance with the Meta-Analysis and Systematic Reviews of Observational Studies (MOOSE) guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). All eligible studies were selected following the PICOS (Population, Intervention, Comparison/Comparator, Outcomes, Study design) model. The values of each outcome measured after VR were compared to the before parameters and, when available, to the values on patients with unrepaired varicocele, and to those of healthy controls with no varicocele. For total testosterone, the values were sub-analyzed based on the mean total testosterone levels before VR (<300 ng/dL or >300 ng/dL), the fertility status, the time of follow-up and the technique used for VR. Results: From a total of 460 abstracts retrieved, 48 articles were included in our meta-analysis. Serum total testosterone levels were significantly higher after VR compared to both pre-treatment levels (mean difference [MD] 82.45 ng/dL, 95% confidence interval [CI]: 64.14-100.76; p<0.00001) and to the levels of patients with unrepaired varicocele (MD 91.64 ng/dL, 95% CI: 62.30-120.99; p<0.00001). They did not differ from the levels of healthy controls with no varicocele (MD -22.01 ng/dL, 95% CI: -68.59-24.58; p=0.35). The increase resulted to be independent from the mean total testosterone levels before VR, fertility status, time of follow-up and type of VR. After VR, a trend toward lower serum LH levels was found compared to before values (MD -0.37 IU/L, 95% CI: -0.74-0.01; p=0.06). When compared to the levels of patients with unrepaired VR, LH levels after VR were significantly lower (MD -0.96 IU/L, 95% CI: -1.56 to -0.35; p=0.002). LH levels were not significantly higher than healthy men without varicocele (MD 0.84 IU/L, 95% CI: -0.68-2.36; p=0.28). Patients with VR had significantly lower FSH levels compared to their pre-treatment values (MD -1.43 IU/L, 95% CI: -1.82 to -1.04; p<0.00001), and also to those of patients with non-repaired varicocele (MD -2.35 IU/L, 95% CI: -4.06 to -0.65; p=0.007). When compared to healthy controls with no varicocele, FSH levels were significantly higher (MD 2.71 IU/L, 95% CI: 1.12-4.31; p=0.0009). Lastly, after VR no significant change in inhibin B serum levels was seen compared to pre-treatment levels (MD 11.76 pg/mL, 95% CI: -3.83-27.35; p=0.14). Conclusions: The present meta-analysis is the largest to date to assess the impact of VR on Leydig cell and Sertoli cell function using a before-after analysis for uncontrolled studies, and using data from patients with unrepaired varicoceles or healthy patients without varicocele as controls. VR was found to increase and restore to normality serum levels of total testosterone and LH. This evidence could be of value in considering the treatment of varicocele in patients with low testosterone or those who show a progressive decline in testosterone levels.
Yazarlar (29)
1
Rossella Cannarella
ORCID: 0000-0003-4599-8487
2
Rupin Shah
ORCID: 0000-0002-7868-5949
3
Edmund Y. Ko
ORCID: 0000-0002-7465-3616
4
Parviz Kavoussi
ORCID: 0000-0001-7390-5837
5
Amarnath Rambhatla
ORCID: 0000-0002-1383-6670
6
Taha Abo Almagd Abdel Meguid Hamoda
ORCID: 0000-0002-8070-4088
7
Ramadan Saleh
ORCID: 0000-0003-0503-3533
8
Ahmed M. Harraz
ORCID: 0000-0002-8902-517X
9
Aldo E. Calogero
ORCID: 0000-0001-6950-335X
10
Damayanthi Durairajanayagam
ORCID: 0000-0001-9049-0215
11
Tuncay Toprak
ORCID: 0000-0003-1348-5273
12
Gokhan Calik
ORCID: 0000-0002-9976-9666
13
Andrea Crafa
ORCID: 0000-0002-8311-9095
14
Sezgin Gunes
ORCID: 0000-0002-3103-6482
15
Nazim Gherabi
ORCID: 0000-0001-7364-047X
16
Shinnosuke Kuroda
ORCID: 0000-0001-8890-0297
17
Hussein Kandil
ORCID: 0000-0002-5549-3274
18
Murat Gul
ORCID: 0000-0002-6657-6227
19
Florence Boitrelle
ORCID: 0000-0002-5322-0141
20
Ramy Abou Ghayda
ORCID: 0000-0002-5170-3983
21
Raghavender Kosgi
ORCID: 0000-0002-2178-0857
22
Vilvapathy Senguttuvan Karthikeyan
ORCID: 0000-0002-0244-476X
23
Giorgio Ivan Russo
ORCID: 0000-0003-4687-7353
24
Selahittin Çayan
ORCID: 0000-0003-4784-2208
25
Rajender Singh
ORCID: 0000-0002-4592-6566
26
Eric Chung
ORCID: 0000-0003-3373-3668
27
Carlo Giulioni
ORCID: 0000-0001-9934-4011
28
Gian Maria Busetto
ORCID: 0000-0002-7291-0316
29
Ashok Agarwal
ORCID: 0000-0003-0585-1026
Anahtar Kelimeler
Follicle stimulating hormone
Hormones
Inhibin B
Luteinizing hormone
Testosterone
Varicocele
Kurumlar
Ajyal Hospital
Sohag Egypt
Apollo Hospitals Group
Chennai India
Apollo Hospitals Hyderabad
Hyderabad India
Austin Fertility & Reproductive Medicine/Westlake IVF
Austin United States
Central Drug Research Institute India
Lucknow India
Centre Hospitalier Intercommunal Poissy-St-Germain-en-Laye
Poissy France
Cleveland Clinic Foundation
Cleveland United States
Faculty of Medicine
Sohag Egypt
Faculty of Medicine
Minya Egypt
Fakih IVF Fertility Center
Abu Dhabi United Arab Emirates
Farwania Hospital
Safat Kuwait
Global Andrology Forum
Moreland Hills United States
Henry Ford Hospital
Detroit United States
İstanbul Medipol Üniversitesi
Istanbul Turkey
King Abdulaziz University
Jeddah Saudi Arabia
Lilavati Hospital & Research Centre, Mumbai
Mumbai India
Loma Linda University Health
Loma Linda United States
Mansoura University, Urology and Nephrology Center
Mansoura Egypt
Mersin Üniversitesi Tip Fakültesi
Mersin Turkey
Ondokuz Mayis Üniversitesi
Samsun Turkey
Sabah Al Ahmad Urology Center
Kuwait City Kuwait
Selçuk Üniversitesi
Selçuklu Turkey
The University of Queensland
Brisbane Australia
Università degli Studi di Catania
Catania Italy
Università degli Studi di Catania, Scuola di Medicina
Catania Italy
Università degli Studi di Foggia
Foggia Italy
Università Politecnica delle Marche
Ancona Italy
Université d’Alger 1
Algiers Algeria
Université de Versailles Saint-Quentin-en-Yvelines
Versailles France
Universiti Teknologi MARA
Shah Alam Malaysia
University Hospitals Case Medical Center
Cleveland United States
University of Health Sciences
Istanbul Turkey
Metrikler
6
Atıf
29
Yazar
6
Anahtar Kelime