TY - JOUR
T1 - Varicocele Management Strategies and Resulting Paternity Rates in a Cohort of Young Adults
AU - Verhovsky, Guy
AU - Neheman, Amos
AU - Rappaport, Yishai Hode
AU - Kedem, Ron
AU - Hofman, Azik
AU - Zisman, Amnon
AU - Haifler, Miki
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/7
Y1 - 2018/7
N2 - Objective: To evaluate the paternity rate in a large cohort of asymptomatic adult varicocele patients undergoing nonsurgical management and surgery. Methods: The study population included 1845 men with varicocele and 9286 healthy controls. All data were retrospectively obtained from the Israeli Defense Forces medical database. Patients were divided according to the management strategy: 1758 (95.2%) were followed up nonsurgically, 63 (3.4%) had preventive surgery (patients without known infertility), and 24 (1.4%) had secondary surgery (patients with varicocele and primary infertility) as young adults. The primary outcome was the live birth rate. Results: The live birth rate was similar in the preventive surgery and control groups. Both preventive surgery and control groups had higher live birth rate than the nonsurgical group. Finally, the secondary surgery group had the lowest live birth rate of all groups. Conclusion: Preventive surgery for asymptomatic varicocele provides similar fertility outcomes to control groups, whereas nonsurgical strategy provides inferior outcomes and may be overutilized.
AB - Objective: To evaluate the paternity rate in a large cohort of asymptomatic adult varicocele patients undergoing nonsurgical management and surgery. Methods: The study population included 1845 men with varicocele and 9286 healthy controls. All data were retrospectively obtained from the Israeli Defense Forces medical database. Patients were divided according to the management strategy: 1758 (95.2%) were followed up nonsurgically, 63 (3.4%) had preventive surgery (patients without known infertility), and 24 (1.4%) had secondary surgery (patients with varicocele and primary infertility) as young adults. The primary outcome was the live birth rate. Results: The live birth rate was similar in the preventive surgery and control groups. Both preventive surgery and control groups had higher live birth rate than the nonsurgical group. Finally, the secondary surgery group had the lowest live birth rate of all groups. Conclusion: Preventive surgery for asymptomatic varicocele provides similar fertility outcomes to control groups, whereas nonsurgical strategy provides inferior outcomes and may be overutilized.
UR - http://www.scopus.com/inward/record.url?scp=85047075610&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2018.04.021
DO - 10.1016/j.urology.2018.04.021
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C2 - 29729366
AN - SCOPUS:85047075610
SN - 0090-4295
VL - 117
SP - 78
EP - 81
JO - Urology
JF - Urology
ER -