(S17) a systemic review exploring the relationship between Varicocele and premature ejaculation

Abstract Background Premature ejaculation (PE) is a male sexual dysfunction characterized by ejaculation that always or nearly always occurs prior to or within a short period of vaginal penetration. Recently, a correlation between varicocele and (PE) has been observed sparking an interest in exploring the effect of varicocele repair on the duration of ejaculation. This work is aimed at systemically reviewing the literature to assess the correlation between (PE) and varicocele through (1) exploring the prevalence of PE in patients with varicocele, (2) reporting the effect of varicocelectomy on the duration of ejaculation or (PE) measures, and (3) assessing the quality of studies investigating this relationship. Methods This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) guidelines. Studies were included if they were original and (1) reported an association between the presence of clinical varicocele and premature ejaculation and/or (2) explored changes in ejaculation latency time after varicocele correction (either by subjective measures or by using objective measurement tools). The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized studies. Results Eight articles met the eligibility criteria and were included in the review. Two of the 8 studies examined the prevalence of (PE) among men with varicocele, reporting a significantly higher prevalence compared to those without varicocele. The remaining 6 studies explored the impact of varicocelectomy on various measures of (PE). Results of these studies were found to be conflicting. Considerable heterogeneity was noted with respect to the methods used in defining (PE) or measuring the outcome of varicocelectomy on ejaculation time. The (NOS) results identified two studies with a score of 8 stars, two studies with 6 stars, one with 5 stars and three with 4 stars. Conclusion (PE) is more prevalent in patients with varicocele in comparison to men without varicocele. Limited evidence suggests that varicocelectomy may be associated with prolongation of ejaculatory time and improvement in (PE). However, further studies are still required before indicating varicocele ligation as a sole treatment modality for patients with (PE).