Effects of Micronised Purified Flavonoid Fraction on Pain, Spermiogram and Scrotal Color Doppler Parameters in Patients with Painful Varicocele

Kılıç, Süleyman; Güneş, Ali; İpek, Davut; Duşak, Abdurrahim; Gunes, Gursel; Balbay,; Baydinç, Yaşar Can

doi:10.1159/000083290

Cited by 13 publications

(6 citation statements)

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“…Another derivative of bioflavanoid in the form of micronized purified flavonoid fraction (MPFF, commonly available as Daflon) was also evaluated to study its effect on pain score, spermiogram, and color Doppler parameters in patients with clinical painful varicocele after treatment for 6 months. 15 It was found that medical therapy resulted in significant relief of varicocele-associated pain ( P < 0.001), improvement in color Doppler parameters (i.e., decrease in the reflux time of left spermatic vein during Valsalva maneuver; P = 0.003), and improvement in sperm motility ( P = 0.009). It did not lead to any improvement in total sperm count, sperm concentration, morphology, and semen volume.…”

Section: Resultsmentioning

confidence: 96%

An update on the role of medical treatment including antioxidant therapy in varicocele

Garg

Kumar

2016

Asian J Androl

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Varicocele-associated male infertility has classically been managed using surgery or assisted reproductive techniques. With increasing evidence of oxidative stress as a pathophysiological factor in varicocele-associated infertility, medical therapy especially antioxidants might become a treatment option with lower risks. We reviewed the existing literature on the role of various medical agents in the management of male infertility attributed to varicoceles. Medical therapy is typically evaluated in three different situations such as (a) comparison of two drugs or one drug with placebo, (b) comparison of drugs versus surgery, and (c) comparison of drugs as adjuvant therapy with surgery versus drug therapy alone. Due to heterogeneity of data and lack of well-conducted studies, there is insufficient data to recommend routine use of medical therapy for men with varicocele-associated infertility and surgery remains the treatment of choice. Pregnancy and live birth rates are usually not reported in most studies and mere improvement in sperm parameters or antioxidant capacity is insufficient to support its routine use. Antioxidant therapy is a potential option due to its theoretical benefit, data from preclinical studies, and lack of major side effects. Adjuvant therapy with antioxidants after surgical repair of varicocele may improve the outcome and is a potential area for further research.

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Section: Resultsmentioning

confidence: 96%

An update on the role of medical treatment including antioxidant therapy in varicocele

Garg

Kumar

2016

Asian J Androl

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“…MPFF or Daflon, a derivative of bioflavonoid, has also been studied by Kilic et al . 62 and Soylemez et al . 63 It is thought that these agents prolong the activity of peripheral norepinephrine and ultimately improving venous tone in varicoceles.…”

Section: Multivitaminsmentioning

confidence: 93%

Current medical management of endocrine-related male infertility

2016

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Male factor contributes to 50%–60% of overall infertility but is solely responsible in only 20% of couples. Although most male factor infertility is ascertained from an abnormal semen analysis, other male factors can be contributory especially if the sample returns normal. Male infertility can be due to identifiable hormonal or anatomical etiologies that may be reversible or irreversible. This manuscript will highlight existing guidelines and our recommendations for hormone evaluation for male infertility and empiric therapies including multivitamins, estrogen receptor modulators (clomiphene), estrogen conversion blockers (anastrozole), and hormone replacement.

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“…Micronised purified flavonoid fraction (MPFF) is an oral phlebotrophic drug that improves the venous tone and elasticity and reduces distension of the veins as well as venous emptying time in patients with chronic venous insufficiency. Kiliç et al [18] that 6 months oral MPFF therapy was safe and effective in a study including 16 patients with painful varicocele. However, no recommendation for the use of MPFF can be made until these preliminary results are confirmed by a randomized, placebo-controlled trial.…”

Section: Treatmentsmentioning

confidence: 99%

Varicocele and Testicular Pain: A Review

Paick

Choi

2019

World J Mens Health

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Varicocele is an abnormal dilatation and tortuosity of the internal spermatic veins within the pampiniform plexus of the spermatic cord [1]. The reported prevalence of varicocele varies; however, it is generally estimated at approximately 15% [2]. Although most men remain asymptomatic, the most common clinical symptoms include infertility and chronic scrotal pain [1]. Varicocele is a major cause of impaired spermatogenesis and the most common correctable cause of male infertility [3]. It is found in approximately 40% of men with primary infertility and in 80% of men with secondary infertility [4]. About 2% to 10% of men with varicocele complain of pain, mainly in the scrotum or in the inguinal area [5]. Varicocelectomy for male infertility has been investigated far more than pain. The cause of pain due to varicocele is not well understood. Hence, we conducted this review focused on pain in varicocele. ETIOLOGYThe etiology of pain associated with varicocele is not completely understood. However, infertility due to varicocele is a possibility, as varicocele affects spermatogenesis and the function of Leydig cells, by increasing the testicular temperature, venous pressure, hypoxia, Varicocele is the dilatation of the scrotal portion of pampiniform plexus and the internal spermatic venous system. About 15% of men suffer from scrotal varicocele and 2% to 10% of them complain of pain. The probable mechanisms for pain include compression of the surrounding neural fibers by the dilated venous complex, elevated testicular temperature, increased venous pressure, hypoxia, oxidative stress, hormonal imbalances, and the reflux of toxic metabolites of adrenal or renal origin. Testicular pain associated with varicoceles is typically described as a dull, aching, or throbbing pain in the testicle, scrotum, or groin; rarely, it can be acute, sharp, or stabbing. The management of testicular pain associated with varicocele starts with a conservative, non-surgical approach and a period of observation. Varicocelectomy in carefully selected candidates with clinically palpable varicocele resolves nearly 80% of all cases of testicular pain. Microsurgical techniques for varicocelectomy have gained popularity with minimal complication rates and favorable outcomes. The grade of varicocele, the nature and duration of pain, body mass index, prior conservative management, and the type of surgical method used, are predictors for the success of varicocelectomy.Keywords: Pain; Review literature as topic; Surgical procedures, operative; Varicocele This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Effects of Micronised Purified Flavonoid Fraction on Pain, Spermiogram and Scrotal Color Doppler Parameters in Patients with Painful Varicocele

Cited by 13 publications

References 50 publications

An update on the role of medical treatment including antioxidant therapy in varicocele

An update on the role of medical treatment including antioxidant therapy in varicocele

Current medical management of endocrine-related male infertility

Varicocele and Testicular Pain: A Review

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