ReviewResearch and reports in urology2025
Beyond Tying Knots: Can Venous Bypass Shape the Future of Testicular Hemodynamics in Varicocele Treatment? - A Systematic Review.
Review in Research and reports in urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Comparison of Laparoscopic Varicocelectomy and Microsurgical Varicocelectomy with Internal Spermatic Vein-Superficial Epigastric Vein Bypass in Adolescent Patients.Children (Basel, Switzerland) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: Varicocele, present in 15-20% of males and linked to 35-40% of primary infertility, is commonly treated with microsurgical ligation. This review compares venous shunting techniques such as spermatic-inferior epigastric vein anastomosis with ligation in terms of efficacy, safety, and clinical outcomes, especially in complex cases like recurrence or Nutcracker Syndrome. Methods: We included randomized, prospective, retrospective, and cohort studies comparing venous shunting (eg, spermatic-inferior epigastric vein anastomosis) with ligation or without control group. We searched PubMed, EBSCO, ProQuest, EMBASE, and Scopus on 31 April 2025. Risk of bias was assessed using the Newcastle-Ottawa Scale and JBI (Joanna Briggs Institute) for case series. Outcomes assessed included operative time, semen parameters, hormonal levels, recurrence, and complications. This study was registered in PROSPERO (CRD420251060842). Results: Twelve studies (n = 420 patients) were included. Shunting demonstrated improvements in semen quality (eg, sperm motility: 59.4% vs 41.6% post-ligation) and lower recurrence rates (0-5% vs 5-15%). However, operative times were longer (99-146 vs 48-92 minutes). Shunting also showed benefits in vascular parameters and testicular volume, particularly in NCS-associated cases. Complications were rare, with minor issues like scrotal edema reported. Conclusion: Venous shunting shows promise as an alternative in selected varicocele patients, with potential benefits in semen motility, pain relief, and recurrence reduction. However, the current evidence is limited, heterogeneous, and largely non-randomized. Shunting should therefore be considered experimental, requiring advanced microsurgical expertise, and further high-quality trials are needed before incorporation into standard guidelines.
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Registered trials
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