M J Sichlau1, J S Yao, R L Vogelzang. 1. Department of Diagnostic Radiology, Northwestern University Medical School, Chicago, Illinois.
Abstract
BACKGROUND: Both medical and surgical treatments have been used for pelvic congestion syndrome. An analogous condition in males, varicocele testis, has been treated successfully for many years by transcatheter embolotherapy. CASES: We performed percutaneous transcatheter embolization of the ovarian veins in three women with chronic pelvic pain and venographically demonstrated pelvic venous congestion. In all three cases, the ovarian veins were embolized bilaterally from the femoral approach, using stainless-steel coils. After the treatment, all subjects experienced a dramatic decrease in pelvic pain, as well as an improvement in two or more preexisting symptoms, including extremity swelling, dyspareunia, external varicosities, constipation, and emotional disturbance. One patient's symptoms recurred at 1.2 years and required surgery; the other two continue to have long-term benefit. CONCLUSION: These findings suggest that pelvic venous congestion was the likely etiologic factor in pelvic pain experienced by these women and that transcatheter ovarian vein embolotherapy may be an effective treatment for such a condition.
BACKGROUND: Both medical and surgical treatments have been used for pelvic congestion syndrome. An analogous condition in males, varicocele testis, has been treated successfully for many years by transcatheter embolotherapy. CASES: We performed percutaneous transcatheter embolization of the ovarian veins in three women with chronic pelvic pain and venographically demonstrated pelvic venous congestion. In all three cases, the ovarian veins were embolized bilaterally from the femoral approach, using stainless-steel coils. After the treatment, all subjects experienced a dramatic decrease in pelvic pain, as well as an improvement in two or more preexisting symptoms, including extremity swelling, dyspareunia, external varicosities, constipation, and emotional disturbance. One patient's symptoms recurred at 1.2 years and required surgery; the other two continue to have long-term benefit. CONCLUSION: These findings suggest that pelvic venous congestion was the likely etiologic factor in pelvic pain experienced by these women and that transcatheter ovarian vein embolotherapy may be an effective treatment for such a condition.