Treatment of symptomatic pelvic varices by ovarian vein embolization.
OBJECTIVE
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.


CONCLUSIONS
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.
Capasso
P
P
Department of Medical Imaging, University Hospital Sart Tilman, B-4000 Liège, Belgium.
Simons
C
C
Trotteur
G
G
Dondelinger
R F
RF
Henroteaux
D
D
Gaspard
U
U
D000328:Adult; D002908:Chronic Disease; D004414:Dyspareunia / Q000209:etiology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply*; D017699:Pelvic Pain / Q000209:etiology; D010388:Pelvis / Q000098:blood supply* / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D012008:Recurrence; D014463:Ultrasonography; D014648:Varicose Veins / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014680:Veins