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CardioVascular and Interventional Radiology

, Volume 20, Issue 2, pp 107–111 | Cite as

Treatment of symptomatic pelvic varices by ovarian vein embolization

  • Patrizio Capasso
  • Christine Simons
  • Geneviève Trotteur
  • Robert F. Dondelinger
  • Denis Henroteaux
  • Ulysse Gaspard
Clinical Investigations

Abstract

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 lumboovarian 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 lumboovarian 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.

Key words

Ovarian varicocele Ovarian venography Embolization Pelvic pain Varices 

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References

  1. 1.
    Hobbs JT (1990) The pelvic congestion syndrome. Br J Hosp Med 43:200–206PubMedGoogle Scholar
  2. 2.
    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 57:637–653PubMedGoogle Scholar
  3. 3.
    Edlundh KO (1964) Pelvic varicosities in women. Acta Obstet Gynecol Scand 43:399–407PubMedCrossRefGoogle Scholar
  4. 4.
    Chidekel N (1968) Female pelvic veins demonstrated by selective renal phlebography with particular reference to pelvic varicosities. Acta Radiol 7:193–211Google Scholar
  5. 5.
    Hodgson TJ, Reed MWR, Peck RJ, Hemingway AP (1991) The ultrasound and Doppler appearances of pelvic varices. Clin Radiol 44:208–209.PubMedCrossRefGoogle Scholar
  6. 6.
    Edwards RD, Robertson IR, MacLean AB, Hemingway AP (1993) Pelvic pain syndrome: Successful treatment of a case by ovarian vein embolization. Clin Radiol 47:429–431PubMedCrossRefGoogle Scholar
  7. 7.
    Sichlau MJ, Yao JST, Vogelzang RL (1994) Transcatheter embolotherapy for the treatment of pelvic congestion syndrome. Obstet Gynecol 83:892–896PubMedGoogle Scholar
  8. 8.
    Beard RW, Highman JH, Pearce S, Reginald PW (1984) Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet II:946–949CrossRefGoogle Scholar
  9. 9.
    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 97:583–587PubMedGoogle Scholar
  10. 10.
    Giachetto C, Catizone F, Cotroneo GB, Cavallaro V, Cammisuli F, Minutolo V, Rodolico G (1989) Radiologic anatomy of the genital venous system in female patients with varicocele. Surg Gynecol Obstet 169:403–407Google Scholar
  11. 11.
    Giachetto C, Cotroneo GB, Marincolo F, Cammisuli F, Caruso G, Catizone F (1990) Ovarian varicocele: Ultrasonic and phlebographic evaluation. J Clin Ultrasound 18:551–555CrossRefGoogle Scholar
  12. 12.
    Kennedy A, Hemingway A (1990) Radiology of ovarian varices. Br J Hosp Med 44:38–43PubMedGoogle Scholar
  13. 13.
    Lechter A (1985) Pelvic varices: Treatment. J Cardiovasc Surg 26:111–112Google Scholar
  14. 14.
    Mathis BV, Miller JS, Lukens ML, Paluzzi MW (1995) Pelvic congestion syndrome: A new approach to an unusual problem. Am Surg 61:1016–1018PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1997

Authors and Affiliations

  • Patrizio Capasso
    • 1
  • Christine Simons
    • 1
  • Geneviève Trotteur
    • 1
  • Robert F. Dondelinger
    • 1
  • Denis Henroteaux
    • 2
  • Ulysse Gaspard
    • 3
  1. 1.Department of Medical ImagingUniversity Hospital Sart TilmanLiègeBelgium
  2. 2.Department of Medical ImagingHôpital La CitadelleLiègeBelgium
  3. 3.Department of GynecologyUniversity Hospital Sart TilmanLiègeBelgium

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