Abstract:
Purpose: Micronised purifi ed fl avonoid fraction (MPFF)
is a phlebotropic drug improving venous tone, elasticity
and lymphatic drainage, decreasing venous distensibility,
venous emptying times, refl ux time of venous blood
and capillary hyperpermeability, and having antioxidant
activities. Since varicocele is a venous pathology, we
evaluated the effects of MPFF on pain, spermiogram and
color Doppler parameters in patients with painful varicocele.
Material and Methods: Semen analyses and
Doppler sonography were performed in 16 patients
(aged 20–62 years, mean 31.2 8 10.9) before and after
1,000 mg/day MPFF treatment. Pain change was assessed
with visual analogue scale scored between 0 and
10. Patient satisfaction with outcome and side effects
were recorded. Results: Mean pain scores at 1, 3, and 6
months were 1.25 8 1.34, 0.25 8 0.68, and 0.12 8 0.34, respectively, all being signifi cantly lower (p ! 0.001 for
each) than baseline (4.93 8 1.77). Mean score at 12
months (0.93 8 1.06) was still lower than baseline (p !
0.001) but higher than at 6 months (p = 0.019). Respectively,
14 (87.5%) and 2 (12.5%) patients reported complete
and very signifi cant resolution of pain at the 6th
month. All patients were very satisfi ed with the outcome.
While semen volume, total sperm count, sperm concentration
and morphology did not change signifi cantly,
motility increased signifi cantly (p = 0.009) due to decrease
of grade 0 sperms (p = 0.006) and increase of
grade 3 + 4 sperms (p ! 0.001). Refl ux time of left spermatic
vein during the Valsalva maneuver decreased signifi
cantly (p = 0.003). No signifi cant change occurred in
refl ux time of the right spermatic vein. No side effect was
recorded. Conclusions: Results of this preliminary study
suggest the safety and effi cacy of MPFF in the treatment
of varicocele-associated pain. However, no recommendation
for the use of MPFF in the treatment of pain associated
with varicocele can be made before these preliminary
results are confi rmed by a randomized pla cebocontrolled
trial.
