Laparoscopic treatment of ovarian vein syndrome.
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.
Gettman
Matthew T
MT
Department of Urology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9110, USA.
Lotan
Yair
Y
Cadeddu
Jeffrey
J
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*