title: Laparoscopic treatment of ovarian vein syndrome.
abstract: BACKGROUND
  Ovarian vein syndrome is a rare cause of teral obstruction. In this report, we describe an unusual presentation of the syndrome successfully treated with laparoscopic techniques.
  
  
  METHODS
  The patient presented with a 12-month history of right flank pain and a right abdominal mass. The preoperative evaluation revealed renal malrotation, hydronephrosis, decreased renal function, and presumed ureteropelvic junction obstruction.
  
  
  RESULTS
  By using a transperitoneal laparoscopic approach, an enlarged ovarian vein was identified as the cause of the ureteral obstruction. The ovarian vein was divided with a laparoscopic stapler. The patient's postoperative course was unremarkable, and she was discharged from the hospital on the second postoperative day. At 3-months follow-up, the patient was completely asymptomatic without evidence of obstruction.
  
  
  CONCLUSIONS
  Ovarian vein syndrome remains a rare diagnosis of exclusion. A careful preoperative evaluation is required to exclude other causes of ureteral obstruction. By using a laparoscopic approach, the ureter and obstructing vessel were readily identified to effectively treat the patient. With the minimally invasive approach, postoperative recovery and patient quality of life were improved.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9110, USA.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
authors.forename: Yair
authors.initials: Y
authors.lastname: Lotan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cadeddu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010053:Ovary / Q000098:blood supply*; D013577:Syndrome; D014517:Ureteral Obstruction / Q000209:etiology* / Q000601:surgery*; D014652:Vascular Diseases / Q000150:complications* / Q000601:surgery*