[A critical analysis of studies of varicocele therapy from the biostatistics viewpoint]

Since approximately 45 years subfertile patients with varicocele are treated with different techniques of a varicocelectomy if there are no (other) causes of infertility. In the meantime, a varicocelectomy is being applied prophylactically in adolescents, too. In this article, there should be investigated whether the conducted clinical trials provide evidence of the efficacy of a varicocelectomy. Due to the fact that there are only a few valuable trials concerning the therapy of varicocele, the meta-analysis is mainly a critical analysis of the considered biostatistical methods. It comes to the conclusion that there is no clinical evidence for efficacy as well as against, and this conclusion is valid for the treatment as well as for the prophylaxis of male factor infertility. To achieve evidence, intensification of cooperation in multicenter study groups is necessary and methodical quality of the clinical trials on varicocelectomy should be improved.