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Abstract

Volume 18, Issue 2 (March 2016) 18, 269–275; DOI:10.4103/1008-682X.172641

The significance of clinical practice guidelines on adult varicocele detection and management

Anand Shridharani, Ryan C Owen, Osama O Elkelany, Edward D Kim

1Department of Urology, University of Tennessee College of Medicine, Chattanooga, TN 37403, USA; 2Division of Urology, Department of Surgery, University of Tennessee
Graduate School of Medicine, Knoxville, TN 37920, USA.

Correspondence: Dr. A Shridharani (anand.shridharani@erlanger.org)

Abstract

Varicoceles are the most common correctable etiology of male factor infertility. However, the detection and management of
varicoceles have not been standardized. This has led to decades of debate regarding the effect of varicocele on male infertility and
subsequently whether repair leads to an improved fertility status. The current body of evidence investigating the role of varicocele
and varicocelectomy is weak and conflicting. The stance taken by the AUA and ASRM suggests that there is insufficient outcomes
data to support evidenced‑based guidelines, citing evidence used to provide current recommendations are generally of a low quality
level. On the other hand, the EAU Guidelines give a level 1a of evidence for management of varicoceles that are clinically palpable,
associated with subnormal semen analyses and having otherwise unexplained fertility. Besides aiding with clinical varicocele
detection and management, clinical practice opinion statements and guidelines aim to direct and strengthen the infrastructure of
future studies. We review the current status of opinion statements and guidelines in varicocele and management detection with
focus on their application in practice.

Full Text | PDF | 中文摘要 |

 
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