Objective: The aim of this study is to compare the results, namely improvement in pelvic pain and overall satisfaction with treatment by surgery, or by coils and sclerotherapy, for pelvic congestion syndrome (PCS) when caused by ovarian vein incompetence based on ultrasound assessment. To do so requires a brief description of the diagnosis of PCS and ovarian vein incompetence, and a discussion of the indications for treatment.
Methods: The same questionnaire as used for a previous surgical series in 1989–95 was used for the present study. Independent assessment of responses to the questionnaire using visual analogue scales, together with review of the clinical notes, enabled statistical evaluation of two treatment groups. Treatment was by surgery from 1989 to 1998, and by coils and sclerotherapy from January 1999 to June 2002. Obtaining demographic and presenting symptom data has enabled us to compare the two groups, as well as the results of the two treatments.
Results: There was no significant difference between the demographics and presenting symptoms of surgical and coil treatment groups. Surgical and coil groups combined show a statistically significant reduction in perceived pelvic pain, and overall satisfaction with treatment. There is no difference in reduction of perceived pelvic pain or in overall satisfaction between surgical and coil treatment groups.
Conclusion: Treatment based on ultrasound diagnosis is justified. Surgical ovarian vein ablation should not be considered as having been superseded by coils. The latter has some advantages but also cost implications. Long-term success of coil treatment has not yet been proven. Recanalization of the ovarian vein, if it occurs, can be treated by further coils or surgery.
