Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis.

Autor:	Cannarella R; Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.; Global Andrology Forum, Moreland Hills, OH, USA., Shah R; Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India., Saleh R; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt., Boitrelle F; Global Andrology Forum, Moreland Hills, OH, USA.; Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.; Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France., Hamoda TAA; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.; Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt., Singh R; Global Andrology Forum, Moreland Hills, OH, USA.; Division of Endocrinology, Central Drug Research Institute, Lucknow, India., Salvio G; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy., Toprak T; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey., Falcone M; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy., Gul M; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Selçuk University School of Medicine, Konya, Turkey., Dimitriadis F; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece., Rambhatla A; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA., Russo GI; Global Andrology Forum, Moreland Hills, OH, USA.; Urology Section, University of Catania, Catania, Italy., Ko E; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Loma Linda University Health, Loma Linda, CA, USA., Zini A; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Surgery, McGill University, Montreal, QC, Canada., Kavoussi P; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA., Phuoc NHV; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam.; Department of Andrology and Nephro-Urology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam., Kandil H; Global Andrology Forum, Moreland Hills, OH, USA.; Fakih IVF Fertility Center, Abu Dhabi, UAE., Ghayda RA; Global Andrology Forum, Moreland Hills, OH, USA.; Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA., Birowo P; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia., Gherabi N; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Medicine, Algiers University, Algiers, Algeria., Ceyhan E; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey., Dong J; Global Andrology Forum, Moreland Hills, OH, USA.; Reproductive Medical Center, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi Province, China., Malhotra V; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, SCM Clinic and Hospital, New Delhi, India., Durairajanayagam D; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia., Kolbasi B; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Histology and Embryology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey., Bahar F; Global Andrology Forum, Moreland Hills, OH, USA.; Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia., Calik G; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Istanbul Medipol University, Istanbul, Turkey., Çayan S; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, University of Mersin School of Medicine, Mersin, Turkey., Pinggera GM; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Medical University Innsbruck, Innsbruck, Austria., Calogero AE; Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.; Global Andrology Forum, Moreland Hills, OH, USA., Rajmil O; Global Andrology Forum, Moreland Hills, OH, USA.; Andrology Department, Fundació Puigvert, Barcelona, Spain.; Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain., Mostafa T; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt., Atmoko W; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia., Harraz AM; Global Andrology Forum, Moreland Hills, OH, USA.; Department of General Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait.; Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait.; Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Le TV; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam.; Department of Andrology and Nephro-Urology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam., de la Rosette J; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Istanbul Medipol Mega University Hospital, Istanbul, Turkey., Hakim L; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, Universitas Airlangga Teaching Hospital, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia., Pescatori E; Global Andrology Forum, Moreland Hills, OH, USA.; Andrology and Reproductive Medicine Unit, Next Fertility GynePro, Bologna, Italy., Sergeyev O; Global Andrology Forum, Moreland Hills, OH, USA.; Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia.; Laboratory of Genetics of Reproductive Disorders, Research Centre for Medical Genetics, Moscow, Russia., Rashed A; Global Andrology Forum, Moreland Hills, OH, USA.; Department of Urology, 6th October University, Tanta, Egypt., Saini P; Global Andrology Forum, Moreland Hills, OH, USA.; Division of Endocrinology, Central Drug Research Institute, Lucknow, India., Agarwal A; Global Andrology Forum, Moreland Hills, OH, USA.; Cleveland Clinic, Cleveland, OH, USA. agarwaa32099@outlook.com.
Jazyk:	angličtina
Zdroj:	The world journal of men's health [World J Mens Health] 2024 Apr; Vol. 42 (2), pp. 321-337. Date of Electronic Publication: 2024 Jan 02.
DOI:	10.5534/wjmh.230235
Abstrakt:	Purpose: Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA). Materials and Methods: A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD). Results: Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD -1.125, 95% confidence interval [CI] -1.410, -0.840; p<0.0001) with high inter-study heterogeneity (I²=90.965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD -1.014, 95% CI -1.263, -0.765; p<0.0001, and SMD -1.495, 95% CI -2.116, -0.873; p<0.0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD -2.197, 95% CI -3.187, -1.207; p<0.0001), sperm chromatin structure assay (SMD -0.857, 95% CI -1.156, -0.559; p<0.0001) or TUNEL (SMD -1.599, 95% CI -2.478, -0.719; p<0.0001). A significant decrease in seminal MDA levels was observed following VR (SMD -2.450, 95% CI -3.903 to -0.997, p=0.001) with high inter-study heterogeneity (I²=93.7%). Conclusions: Using pre- and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients. Competing Interests: The authors have nothing to disclose. (Copyright © 2024 Korean Society for Sexual Medicine and Andrology.)
Databáze:	MEDLINE
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