INVITED REVIEW
Year : 2016  |  Volume : 18  |  Issue : 2  |  Page : 269-275

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


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

Correspondence Address:
Dr. Anand Shridharani
Department of Urology, University of Tennessee College of Medicine, Chattanooga, TN 37403
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1008-682X.172641

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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.


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