Int J Angiol 2016; 25(02): 121-127
DOI: 10.1055/s-0035-1570118
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Secondary Varicose Small Pelvic Veins and Their Treatment with Micronized Purified Flavonoid Fraction

Yurii T. Tsukanov
1   Department of Surgical Diseases and Urology for Postgraduate Education, Omsk State Medical Academy, Omsk, Russia
,
Anton Y. Tsukanov
1   Department of Surgical Diseases and Urology for Postgraduate Education, Omsk State Medical Academy, Omsk, Russia
,
Evgenii G. Levdanskiy
1   Department of Surgical Diseases and Urology for Postgraduate Education, Omsk State Medical Academy, Omsk, Russia
› Author Affiliations
Further Information

Publication History

10 April 2015

10 November 2015

Publication Date:
31 December 2015 (online)

Abstract

The aim of this study was to examine secondary varicose small pelvic veins (VSPV) and their treatment with micronized purified flavonoid fraction (MPFF). We examined 70 patients with a history of acute iliac thrombosis of > 1 year. Patients with urination difficulties associated with other symptoms (n = 24) received MPFF 1,000 mg once daily for 1 month. Clinical manifestations were assessed by collecting complaints and analyzing results of physician examinations. VSPV was identified in 48 (68.6%) patients, the majority (58%) had grade 2 (7.0–9.0 mm) venous dilation. VSPV severity correlated with time since the thrombotic event. In most women, varicosities were found in the parametrial venous plexus (mean vein diameter 7.91 mm); retrograde flow during the Valsalva maneuver was found in 14 (78%). In men, all varicosities occurred in the paraprostatic plexus (mean vein diameter 7.20 mm); retrograde flow was found in 21 (70%). MPFF significantly reduced VSPV dilation in 18 (75%) patients (p = 0.0863) and returned ultrasonic indices to normal values in the remainder. Patients with bilateral varices decreased from 10 to 2. Only four patients had retrograde flow in the SPV plexus after treatment. MPFF decreased mean paraprostatic vein diameter in men and parametrial vein diameter in women to near-normal values. Clinical improvement was reported in 13 (54%) patients. Patients with pelvic pain decreased from 8 to 1 and patients with urination disorders from 24 to 9. VSPV is common in patients with a history of iliac vein thrombosis. MPFF decreases the diameter of affected veins, improves retrograde flow and pelvic hemodynamics, and significantly reduces the severity of the clinical manifestations.