Abstract：
OBJECTIVE: To assess the association between varicocele and hypogonadism, or erectile dysfunction.
METHODS: We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager 5.3 and reported information about the Odds Ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.
RESULTS: We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR 3.27 95% CI 1.23 to 8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.
CONCLUSIONS: There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.
METHODS: We searched MEDLINE, EMBASE, LILACS, CENTRAL, and other sources. We included cohort, case-control, and cross-sectional studies. The primary outcome was the association between varicocele and hypogonadism, or erectile dysfunction, and the secondary outcome included semen analysis. We assessed the risk of bias with the Newcastle-Ottawa Scale. We performed statistical analysis in Review Manager 5.3 and reported information about the Odds Ratio (OR) with a 95% confidence interval. We produced a forest plot for the primary outcome.
RESULTS: We included ten studies in qualitative analysis and six studies in quantitative analysis. Most of the cross-sectional studies showed a low risk of bias, not so for the two case-control studies, which represented a high risk of bias. Most of the reports described a correlation between having varicocele and presenting low testosterone levels: the meta-analysis showed that there is a significant association between varicocele and hypogonadism (OR 3.27 95% CI 1.23 to 8.68). Regarding varicocele and erectile, only one study showed a significant difference in erectile function in comparison to varicocele patients and men without varicocele.
CONCLUSIONS: There is an association between varicocele presence and hypogonadism, although more studies are needed. Besides, not much is reported about an association between varicocele and erectile dysfunction, but impairment can occur through hormone disturbances.
摘要：
目的：评估精索静脉曲张与性腺功能减退症之间的关系，或勃起功能障碍。
方法：我们搜索了MEDLINE，EMBASE,LILACS,中部,和其他来源。我们包括队列，病例控制，和横断面研究。主要结果是精索静脉曲张和性腺功能减退之间的关联，或者勃起功能障碍，次要结局包括精液分析。我们用纽卡斯尔-渥太华量表评估了偏倚的风险。我们在ReviewManager5.3中进行了统计分析，并以95％的置信区间报告了有关赔率比（OR）的信息。我们为主要结果制作了一个森林地块。
结果：我们纳入了10项定性分析研究和6项定量分析研究。大多数横断面研究显示偏见的风险较低，两个病例对照研究并非如此，这代表了偏见的高风险。大多数报告描述了精索静脉曲张与低睾酮水平之间的相关性：荟萃分析显示精索静脉曲张与性腺机能减退之间存在显着关联（OR3.2795CI1.23至8.68）。关于精索静脉曲张和勃起，只有一项研究显示，与精索静脉曲张患者和没有精索静脉曲张的男性相比，勃起功能存在显着差异。
结论：精索静脉曲张的存在与性腺功能减退之间存在关联，虽然还需要更多的研究。此外,关于精索静脉曲张和勃起功能障碍之间的关联的报道不多，但是激素紊乱可能会导致损伤。
方法：我们搜索了MEDLINE，EMBASE,LILACS,中部,和其他来源。我们包括队列，病例控制，和横断面研究。主要结果是精索静脉曲张和性腺功能减退之间的关联，或者勃起功能障碍，次要结局包括精液分析。我们用纽卡斯尔-渥太华量表评估了偏倚的风险。我们在ReviewManager5.3中进行了统计分析，并以95％的置信区间报告了有关赔率比（OR）的信息。我们为主要结果制作了一个森林地块。
结果：我们纳入了10项定性分析研究和6项定量分析研究。大多数横断面研究显示偏见的风险较低，两个病例对照研究并非如此，这代表了偏见的高风险。大多数报告描述了精索静脉曲张与低睾酮水平之间的相关性：荟萃分析显示精索静脉曲张与性腺机能减退之间存在显着关联（OR3.2795CI1.23至8.68）。关于精索静脉曲张和勃起，只有一项研究显示，与精索静脉曲张患者和没有精索静脉曲张的男性相比，勃起功能存在显着差异。
结论：精索静脉曲张的存在与性腺功能减退之间存在关联，虽然还需要更多的研究。此外,关于精索静脉曲张和勃起功能障碍之间的关联的报道不多，但是激素紊乱可能会导致损伤。
