[en] PURPOSE: Pelvic congestion syndrome is a common cause of chronic pelvic pain in women and its association with venous congestion has been described in the literature. We evaluated the potential benefits of lumbo-ovarian vein embolization in the treatment of lower abdominal pain in patients presenting with pelvic varicosities. METHODS: Nineteen patients were treated. There were 13 unilateral embolizations, 6 initial bilateral treatments and 5 treated recurrences (a total of 30 procedures). All embolizations were performed with either enbucrilate and/or macrocoils, and there was an average clinical and Doppler duplex follow-up of 15.4 months. RESULTS: The initial technical success rate was 96.7%. There were no immediate or long-term complications. Variable symptomatic relief was observed in 73.7% of cases with complete responses in 57.9%. All 8 patients who had partial or no pain relief complained of dyspareunia. The direct relationship between varices and chronic pelvic pain was difficult to ascertain in a significant number of clinical failures. CONCLUSION: Transcatheter embolization of lumbo-ovarian varices is a safe technique offering symptomatic relief of pelvic pain in the majority of cases. The presence of dyspareunia seemed to be a poor prognostic factor, indicating that other causes of pelvic pain may coexist with pelvic varicosities.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Capasso, P. ; Université de Liège - ULiège > Relations académiques et scientifiques (Médecine)
Simons, Christine
Trotteur, Geneviève ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
DONDELINGER, Robert ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiodiagnostic
Henroteaux, Denis
Gaspard, Ulysse ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
Language :
English
Title :
Treatment of Symptomatic Pelvic Varices by Ovarian Vein Embolization
Hobbs JT (1990) The pelvic congestion syndrome. Br J Hosp Med 43:200-206
Taylor HC Jr (1949) Vascular congestion and hyperemia; their effect on function in the female reproductive organs. II. Clinical aspects of the congestion fibrosis syndrome. Am J Obstet Gynecol 57:637-653
Edlundh KO (1964) Pelvic varicosities in women. Acta Obstet Gynecol Scand 43:399-407
Chidekel N (1968) Female pelvic veins demonstrated by selective renal phlebography with particular reference to pelvic varicosities. Acta Radiol 7:193-211
Hodgson TJ, Reed MWR, Peck RJ, Hemingway AP (1991) The ultrasound and Doppler appearances of pelvic varices. Clin Radiol 44:208-209
Edwards RD, Robertson IR, MacLean AB, Hemingway AP (1993) Pelvic pain syndrome: Successful treatment of a case by ovarian vein embolization. Clin Radiol 47:429-431
Sichlau MJ, Yao JST, Vogelzang RL (1994) Transcatheter embolotherapy for the treatment of pelvic congestion syndrome. Obstet Gynecol 83:892-896
Beard RW, Highman JH, Pearce S, Reginald PW (1984) Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet II:946-949
Adams J, Reginald PW, Franks S, Wadsworth J, Beard RW (1990) Uterine size and endometrial thickness and the significance of cystic ovaries in women with pelvic pain due to congestion. Br J Obstet Gynaecol 97:583-587
Giachetto C, Catizone F, Cotroneo GB, Cavallaro V, Cammisuli F, Minutolo V, Rodolico G (1989) Radiologie anatomy of the genital venous system in female patients with varicocele. Surg Gynecol Obstet 169:403-407