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Effects of micronised purified flavonoid fraction on pain, semen analysis and scrotal color Doppler parameters in patients with painful varicocele; results of a randomized placebo-controlled study

Abstract

Aim

Aim of this study is to evaluate the effects of micronised purified flavonoid fraction (Daflon®) on pain, semen analysis and color Doppler parameters in patients with painful varicocele.

Materials and methods

Forty varicocele patients whom have normal sperm concentration (>20 million/ml) were involved in the study. The patients were divided into two groups such as Daflon (n = 20) and placebo (n = 20) group. Pain score, semen analyses and Doppler sonography were performed in all patients before and after the treatment.

Results

In the first group, mean pain scores at 1, 3, 6 and 12 months were 1.80 ± 1.32, 1.15 ± 0.93, 1.05 ± 0.95 and 0.95 ± 0.89, respectively, all were significantly lower (P < 0.001 for each) than baseline (5.25 ± 1.07). While semen volume, total sperm count, sperm concentration and morphology were not changed significantly, the motility of sperm increased significantly (P = 0.015) due to decrease in grade 1 sperms at the 6th month in the first group. Reflux time of left spermatic vein during the Valsalva maneuver decreased significantly (P < 0.001).

Conclusions

Results of this study suggest the safety and efficacy of Daflon in the treatment of varicocele-associated pain. However, these results of the present study must be confirmed by randomized placebo-controlled studies by using different drug doses and durations before making any recommendation for the use of Daflon.

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References

  1. Greenfield SP, Seville P, Wan J (2002) Experience with varicoceles in children and young adults. J Urol 168:1684–1688

    PubMed  Article  Google Scholar 

  2. Kibar Y, Seckin B, Erduran D (2002) The effects of subinguinal varicocelectomy on Kruger morphology and semen parameters. J Urol 168:1071–1074

    PubMed  Article  Google Scholar 

  3. Turek P, Lipshultz L (1995) The varicocele controversies. I. Etiology and pathophysiology. AUA Update Series, vol 24. American Urological Association, Houston, pp 105–112

  4. Cayan S, Akbay E, Bozlu M, Doruk E, Erdem E, Acar D, Ulusoy E (2002) The effect of varicocele repair on testicular volume in children and adolescents with varicocele. J Urol 168:731–734

    PubMed  Article  Google Scholar 

  5. Maghraby HA (2002) Laparoscopic varicocelectomy for painful varicoceles: merits and outcomes. J Endourol 16:107–110

    PubMed  Article  Google Scholar 

  6. Struckmann JR (1999) Clinical efficacy of micronized purified flavonoid fraction: An overview. J Vasc Res 36 Suppl 1:37–41

    PubMed  Article  CAS  Google Scholar 

  7. Danielsson G, Jungbeck C, Peterson K, Norgren L (2002) A randomised controlled trial of micronised purified flavonoid fraction vs placebo in patients with chronic venous disease. Eur J Vasc Endovasc Surg 23:73–76

    PubMed  Article  CAS  Google Scholar 

  8. Cypriani B, Limasset B, Carrie ML, Le Doucen C, Roussie M, de Paulet AC, Damon M (1993) Antioxidant activity of micronized diosmin on oxygen species from stimulated human neutrophils. Biochem Pharmacol 45:1531–1535

    PubMed  Article  CAS  Google Scholar 

  9. Kilic S, Gunes A, Ipek D, Dusak A, Gunes G, Balbay MD, Baydinc YC (2005) Effects of micronised purified flavonoid fraction on pain, spermiogram and scrotal color Doppler parameters in patients with painful varicocele. Urol Int 74:173–179

    PubMed  Article  CAS  Google Scholar 

  10. Dubin L, Amelar RD (1970) Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertil Steril 21:606–609

    PubMed  CAS  Google Scholar 

  11. Oyen RH (2002) Scrotal ultrasound. Eur Radiol 12:19–34

    PubMed  Article  Google Scholar 

  12. World Health Organization (2010) Appendıx 1: reference values and semen nomenclature. In: Who laboratory manual for the examination and processing of human semen, 5th edn. WHO press, Geneva. pp 223–225

  13. Lasagna L (1960) The clinical measurement of pain. Ann N Y Acad Sci 86:28–37

    PubMed  Article  CAS  Google Scholar 

  14. Biggers RD, Soderdahl DW (1981) The painful varicocele. Mil Med 146:440–441

    PubMed  CAS  Google Scholar 

  15. Iselin CE, Almagbaly U, Borst F, Rohner S, Schmidlin F, Campana A, Graber P (1997) Safety and efficiency of laparoscopic varicocelectomy in one hundred consecutive cases. Urol Int 58:213–217

    PubMed  Article  CAS  Google Scholar 

  16. Peterson AC, Lance RS, Ruiz HE (1998) Outcomes of varicocele ligation done for pain. J Urol 159:1565–1567

    PubMed  Article  CAS  Google Scholar 

  17. Yaman O, Ozdiler E, Anafarta K, Gogus O (2000) Effect of microsurgical subinguinal varicocele ligation to treat pain. Urology 55:107–108

    PubMed  Article  CAS  Google Scholar 

  18. Yeniyol CO, Tuna A, Yener H, Zeyrek N, Tilki A (2003) High ligation to treat pain in varicocele. Int Urol Nephrol 35:65–68

    PubMed  Article  Google Scholar 

  19. Ribe N, Manasia P, Sarquella J, Grimaldi S, Pomerol JM (2002) Clinical follow-up after subinguinal varicocele ligation to treat pain. Arch Ital Urol Androl 74:51–53

    PubMed  Google Scholar 

  20. Zampieri N, Pellegrino M, Ottolenghi A, Camoglio FS (2010) Effects of bioflavonoids in the management of subclinical varicocele. Pediatr Surg Int 26:505–508

    PubMed  Article  Google Scholar 

  21. Nagler H, Luntz R, Martinis F (1997) Varicocele. In: Lipshultz LI, Howards SS (eds) Infertility in the Male. 3. St Louis, Mosby, pp 336–360

    Google Scholar 

  22. Dubin L, Amelar RD (1977) Varicocelectomy: 986 cases in a twelve-year study. Urology 10:446–449

    PubMed  Article  CAS  Google Scholar 

  23. Check JH (1980) Improved semen quality in subfertile males with varicocele-associated oligospermia following treatment with clomiphene citrate. Fertil Steril 33:423–426

    PubMed  CAS  Google Scholar 

  24. Netto NR Jr, Lemos GC, Claro JF (1987) Varicocele: medical and surgical treatment. Int J Fertil 32:432–435

    PubMed  Google Scholar 

  25. Unal D, Yeni E, Verit A, Karatas OF (2001) Clomiphene citrate versus varicocelectomy in treatment of subclinical varicocele: a prospective randomized study. Int J Urol 8:227–230

    PubMed  Article  CAS  Google Scholar 

  26. Raman JD, Schlegel PN (2002) Aromatase inhibitors for male infertility. J Urol 167:624–629

    PubMed  Article  CAS  Google Scholar 

  27. Cavallini G, Biagiotti G, Ferraretti AP, Gianaroli L, Vitali G (2003) Medical therapy of oligoasthenospermia associated with left varicocele. BJU Int 91:513–518

    PubMed  Article  CAS  Google Scholar 

  28. Hendin BN, Kolettis PN, Sharma RK, Thomas AJ Jr, Agarwal A (1999) Varicocele is associated with elevated spermatozoal reactive oxygen species production and diminished seminal plasma antioxidant capacity. J Urol 161:1831–1834

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Haluk Söylemez.

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Söylemez, H., Kiliç, S., Atar, M. et al. Effects of micronised purified flavonoid fraction on pain, semen analysis and scrotal color Doppler parameters in patients with painful varicocele; results of a randomized placebo-controlled study. Int Urol Nephrol 44, 401–408 (2012). https://doi.org/10.1007/s11255-011-0038-3

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  • DOI: https://doi.org/10.1007/s11255-011-0038-3

Keywords

  • Conservative treatment
  • Micronised purified flavonoid fraction
  • Pain
  • Semen analysis
  • Varicocele