Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Contemporary challenges and advanced technologies in the management of subfertile men with varicocele
Desafíos contemporáneos y tecnologías avanzadas en el manejo de hombres subfértiles con varicocele
1Urology Department, Tashkent Medical Academy, 100109 Tashkent, Uzbekistan
2Surgical Department, Republican Specialized Scientific-Practical Medical Center of Urology, 100109 Tashkent, Uzbekistan
DOI: 10.22514/j.androl.2024.017 Vol.22,Issue 3,September 2024 pp.9-15
Submitted: 18 May 2024 Accepted: 30 July 2024
Published: 30 September 2024
*Corresponding Author(s): Azizbek Shomarufov E-mail: a.shomarufov@tma.uz
Varicocele, closely linked to male fertility, requires urgent and focused research due to many unresolved questions. The absence of clear reference values distinguishing “normal” from “abnormal” semen parameters in the 6th World Health Organization (WHO) laboratory manual significantly complicates diagnosis and treatment. Additionally, the clinical relevance of total progressively motile sperm count (TMSC) remains unclear, leaving practitioners without critical guidance. The decision to perform varicocelectomy, particularly in cases of isolated teratozoospermia, is fraught with uncertainty. Furthermore, the best treatment strategy for those experiencing subfertility after varicocele surgery is still undetermined, adding another layer of complexity. These pressing issues, along with contentious debates surrounding isolated teratozoospermia treatment, highlight the need for large-scale multicenter randomized clinical trials. Such studies are essential to fully understand varicocele’s impact on male fertility and to develop evidence-based management protocols.
Resumen
El varicocele, estrechamente vinculado a la fertilidad masculina, requiere una investigación urgente y focalizada debido a muchas preguntas sin resolver. La ausencia de valores de referencia claros que distingan los parámetros del semen “normales” de los “anormales” en el sexto manual de laboratorio de la Organización Mundial de la Salud (OMS) complica significativamente el diagnóstico y el tratamiento. Además, la relevancia clínica del conteo total de espermatozoides móviles progresivamente (TMSC) sigue vaga, dejando a los profesionales sin una guía crítica. La decisión de realizar una varicocelectomía, especialmente en casos de teratozoospermia aislada, está llena de incertidumbre. Además, la mejor estrategia de tratamiento para aquellos que experimentan subfertilidad después de la cirugía de varicocele aún no se ha determinado, añadiendo otra capa de complejidad. Estas cuestiones urgentes, junto con los debates contenciosos en torno al tratamiento de la teratozoospermia aislada, subrayan la necesidad de ensayos clínicos aleatorizados multicéntricos a gran escala. Tales estudios son esenciales para comprender completamente el impacto del varicocele en la fertilidad masculina y para desarrollar protocolos de manejo basados en la evidencia.
Varicocele; Varicocelectomy; Semen parameters; Subfertility
Palabras Clave
Varicocele; Varicocelectomía; Parámetros del semen; Subfertilidad
Azizbek Shomarufov,Farkhad Akilov,Shukhrat Mukhtarov. Contemporary challenges and advanced technologies in the management of subfertile men with varicoceleDesafíos contemporáneos y tecnologías avanzadas en el manejo de hombres subfértiles con varicocele. Revista Internacional de Andrología. 2024. 22(3);9-15.
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