Embolotherapy for pelvic congestion syndrome: long-term results.
OBJECTIVE
To evaluate the long-term clinical outcome of transcatheter embolotherapy in women with chronic pelvic pain caused by ovarian and pelvic varices.


METHODS
The study population included consecutive patients referred to a tertiary-care interventional radiology service from 1998 to 2003 because of a high degree of clinical suspicion of pelvic and ovarian varices. Visual analog scales and questionnaires during clinic visits were used to measure pain perception levels. Basal female hormonal levels were obtained and compared.


RESULTS
Of 131 patients referred (mean age, 34.0 years+/-12.5), percutaneous transfemoral venography confirmed the presence of ovarian varices in 127 (97.0%), all of whom were treated with embolotherapy. Internal iliac embolotherapy was performed in 108 of 127 patients (85.0%). Ninety-seven patients completed long-term clinical follow-up (mean 45 months+/-18). The mean pelvic pain level had improved significantly from 7.6+/-1.8 before embolotherapy to 2.9+/-2.8 after embolotherapy (P<.0001). Significant improvement in each category of specific symptoms was also noted (P<.0001). Overall, 83% of the patients exhibited clinical improvement at long-term follow-up, 13% had no significant change, and 4% exhibited worsened condition. No significant change was noted in hormone levels after embolotherapy. Two successful pregnancies were noted after ovarian and pelvic vein embolotherapy.


CONCLUSIONS
Direct venographic evaluation with embolotherapy can achieve significant improvement in pain perception levels in patients with chronic pelvic pain caused by pelvic venous congestion.
Kim
Hyun S
HS
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-4010, USA. sikhkim@jhmi.edu
Malhotra
Amit D
AD
Rowe
Peter C
PC
Lee
Judy M
JM
Venbrux
Anthony C
AC
D000328:Adult; D002908:Chronic Disease; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010053:Ovary / Q000098:blood supply; D017699:Pelvic Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010388:Pelvis / Q000098:blood supply; D015641:Radiography, Interventional; D012720:Severity of Illness Index; D013577:Syndrome; D016896:Treatment Outcome; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis / Q000628:therapy*