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Abstract

Introduction

With greater than one-tenth of outpatient gynecology visits attributed to chronic pelvic pain, research into etiology and management of the spectra of chronic pain disorders is very important. One such etiology, pelvic congestion syndrome (PCS), is a disease in which pelvic varicosities are present as a result of dysfunctional venous valves, retrograde blood flow, venous hypertension, and dilation. The presence of these varicosities, which exist in up to 10% of women between 18 and 76 years of age, can be detected by various imaging techniques including ultrasound, contrasted computed tomography, and magnetic resonance imaging. Various treatment methodologies have been described for the management of this chronic pain disorder, including medical, endovascular, and surgical therapies. With advancements in imaging, and the opportunity for endovascular intervention via interventional radiology, minimally invasive left ovarian vein embolization is at the forefront of therapeutic efforts for this nefarious condition.

Methods

We present here our clinical experience of 9 patients with PCS who underwent left ovarian vein embolization using a standardized protocol.

Results

Subjective pain relief was noted in 8 of 9 patients; 7 of the 9 patients reported complete resolution of pain at the 4-week follow-up, and associated symptoms similarly resolved.

Conclusions

Any thorough evaluation of a patient with chronic pelvic pain should include an evaluation for PCS when the diagnosis is not immediately available. Increased physician awareness of PCS is imperative for the future. With these astounding results, we recommend an excellent option for treatment of patients with left ovarian vein embolization.

Keywords

Embolization Ovarian vein embolotherapy Pelvic congestion syndrome (PCS)Pelvic pain Pelvic varices

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References

Ignacio

et al.

Pelvic congestion syndrome: diagnosis and treatment.

Semin Intervent Radiol 200825 4 361–8

Knuttinen

et al.

Pelvic venous insufficiency: imaging diagnosis, treatment approaches, and therapeutic issues.

AJR Am J Roentgenol 2015204 2 448–58

Phillips

et al.

Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management.

J Vasc Interv Radiol 201425 5 725–33

Ball

Khan

and Meads

Does pelvic venous congestion syndrome exist and can it be treated?

Acta Obstet Gynecol Scand 201291 5 525–8

Arnoldussen

de Wolf

and Wittens

Wittens, Diagnostic imaging of pelvic congestive syndrome.

Phlebology 201530 1 Suppl 67–72

Belenky

et al.

Ovarian varices in healthy female kidney donors: incidence, morbidity, and clinical outcome.

AJR Am J Roentgenol 2002179 3 625–7

Soysal

et al.

A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion.

Hum Reprod 200116 5 931–9

Edwards

Case report: pelvic pain syndrome–successful treatment of a case by ovarian vein embolization.

Clin Radiol 199347 6 429–31

Hansrani

et al.

Trans-venous occlusion of incompetent pelvic veins for chronic pelvic pain in women: a systematic review.

Eur J Obstet Gynecol Reprod Biol 2015185 156–63

10.

Meissner

and Gibson

Clinical outcome after treatment of pelvic congestion syndrome: sense and nonsense.

Phlebology 201530 1 Suppl 73–80

11.

Lopez

Female Pelvic Vein Embolization: Indications, Techniques, and Outcomes.

Cardiovasc Intervent Radiol 201538 4 806–20

12.

Carr

and Tefera

Surgical treatment of ovarian vein thrombosis.

Vasc Endovascular Surg 200640 6 505–8

A Modern Radiologic Treatment for Pelvic Congestion Syndrome Associated with Chronic Pelvic Pain and Menstrual Abnormalities

Abstract

Introduction

Methods

Results

Conclusions

Keywords

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References