Trial reportInternational urology and nephrology2018
Bilateral is superior to unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele: a prospective randomized controlled study.
Trial report in International urology and nephrology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Surgical or radiological treatment for varicoceles in subfertile men.The Cochrane database of systematic reviews · 2021Pooled it
- Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations.Journal of ultrasound · 2020Pooled it
- Predictors of microsurgical varicocelectomy efficacy in male infertility treatment: critical assessment and systematization.Asian journal of andrologyPooled it
- Is Varicocele Truly Unilateral? Contralateral Involvement and Bilateral Testicular Effects in Male Infertility: A Narrative Review.Journal of personalized medicine · 2026Review
- Varicocelectomy in men with varicocele-associated infertility: a narrative review of semen quality and reproductive outcomes.Translational andrology and urology · 2026Review
- Comparison of DNA fragmentation index and fertility rate after unilateral and bilateral microsurgical varicocelectomy.European journal of translational myology · 2025Article
- Is varicocele repair justified in infertile men with clinical varicocele, normal conventional semen parameters and elevated sperm DNA fragmentation (SDF)?Arab journal of urology · 2025Review
- Testicular arterial blood flow volume in predicting semen improvement following microscopic subinguinal varicocelectomy.Quantitative imaging in medicine and surgery · 2024Article
- The Andrological Landscape in the Twenty-First Century: Making Sense of the Advances in Male Infertility Management for the Busy Clinicians.International journal of environmental research and public health · 2024Review
- Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis.The world journal of men's health · 2024Article
- Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data.The world journal of men's health · 2024Article
- Varicocele: To Treat or Not to Treat?Journal of clinical medicine · 2023Review
- Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations.The world journal of men's health · 2023Article
- Outcome reporting across randomized controlled trials evaluating potential treatments for male infertility: a systematic review.Human reproduction open · 2022Review
- Jiawei Runjing Decoction Improves Spermatogenesis of Cryptozoospermia With Varicocele by Regulating the Testicular Microenvironment: Two-Center Prospective Cohort Study.Frontiers in pharmacology · 2022Article
- Therapeutic Potential of Date Palm against Human Infertility: A Review.Metabolites · 2021Review
- The usefulness of elastography in the evaluation and management of adult men with varicocele: A systematic review.Arab journal of urology · 2021Article
- Sperm DNA Fragmentation: A New Guideline for Clinicians.The world journal of men's health · 2020Review
- Recent advances and controversies in diagnosing and treating male infertility.Faculty reviews · 2020Review
- Some of the Factors Involved in Male Infertility: A Prospective Review.International journal of general medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study is to compare the effect of bilateral versus unilateral varicocelectomy on seminal response and spontaneous pregnancy rates in infertile male patients with left clinical and right subclinical varicocele.
methodsA total of 358 infertile men with left clinical and right subclinical varicocele were randomized to group that underwent bilateral (n = 179) and group that underwent unilateral microsurgical subinguinal varicocelectomy (n = 179). Baseline data regarding male age, female partner age, grade of varicocele body mass index, bilateral testicular volume and serum follicle-stimulating hormone, luteinizing hormone, total testosterone levels and infertility duration and semen parameters were gathered. One year after the surgery, semen parameters including sperm volume, sperm concentration, normal sperm morphology, progressive motility and sperm DNA fragmentation index were recorded and any pregnancy was also documented via telephone calls and hospital visits.
resultsWe found the baseline characteristics were comparable between the two groups. The seminal parameters had significant improvements 1 year postoperatively in both groups. However, the bilateral group showed significantly greater improvements than the unilateral group in sperm concentration, normal sperm morphology and progressive motility. Besides, the pregnancy rate was statistically higher in the bilateral group after the surgery (42.5 versus 26.0%, bilateral versus unilateral group).
conclusionIn conclusion, our study indicated that bilateral is superior to unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele, which is associated with greater improvements in sperm concentration, normal sperm morphology and progressive motility and spontaneous pregnancy rate after the surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.