Medical therapy of oligoasthenospermia associated with left varicocele.

Abstract

OBJECTIVE:

To ascertain whether a nonsteroidal anti-inflammatory drug (cinnoxicam) or surgical varicocelectomy are suitable therapies for oligoasthenospermia associated with varicocele.

PATIENTS AND METHODS:

Patients who were oligoasthenospermic and had a varicocele were blindly randomized into three groups and the varicocele graded using echo-colour Doppler ultrasonography. In group 1, seven men had grade V, four grade IV and 30 grade III varicoceles; in group 2 eight had grade V, 10 grade IV and 43 grade III; in group 3 six had grade V, eight grade IV and 40 grade III. Group 1 underwent surgery, group 2 received cinnoxicam (one 30 mg suppository every 4 days for 12 months) and group 3 received a placebo (one glycerine suppository every 4 days for 12 months). Sperm was analysed at intervals to follow the response in the three groups, and any side-effects considered.

RESULTS:

Surgery significantly increased sperm values in men with grade III-V varicocele within 4 months, the highest values being obtained at 8 and 12 months. Cinnoxicam significantly improved sperm quality after 2 months in men with grade III varicocele, but the results were best at 4 months and stable at 12 months; stopping therapy caused a decline to the baseline values. Cinnoxicam did not change the sperm quality of men with grade IV or V varicocele. The placebo was inactive, and there were no side-effects of active treatment.

CONCLUSIONS:

Cinnoxicam is a safe and reliable therapeutic option for men with oligoasthenospermia associated with a grade III varicocele, but surgery is better for those with grade II, IV and V.

• Authors: G Cavallini, G Biagiotti, A P Ferraretti, L Gianaroli, G Vitali
• Journal: BJU international (BJU Int) Vol. 91 Issue 6 Pg. 513-8 (Apr 2003) ISSN: 1464-4096 [Print] England
• PMID: 12656905 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Piroxicam
• piroxicam cinnamate

Topics

• Adult
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Humans
• Male
• Oligospermia (drug therapy, etiology)
• Piroxicam (analogs & derivatives, therapeutic use)
• Sperm Count
• Ultrasonography, Doppler, Color
• Varicocele (complications, diagnostic imaging)