Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome.
OBJECTIVE
To evaluate the safety and effectiveness of transcatheter embolization using coils for treatment of pelvic congestion syndrome (PCS) and to elucidate prognostic factors for clinical success.


METHODS
Data were retrospectively analyzed from 113 women with PCS who underwent endovascular embolization of ovarian and pelvic varicose veins at Hospital Clínico Universitario, Zaragoza, Spain between January 2001 and January 2011. Pain score was evaluated before and after the procedure via a visual analog scale (VAS). Associated symptoms (dysmenorrhea, dyspareunia, urinary urgency, and lower limb symptoms) were also evaluated. Patients were followed up for 12 months.


RESULTS
The technical and clinical success was 100%. At 12 months, 53% of patients had no pelvic pain and 47% reported a reduction in pelvic pain. The average VAS was 7.34 before the procedure and 0.47 at 12 months. Complete relief of pain and associated symptoms was achieved for 37% of patients. Urinary urgency, lower limb symptoms, and vulvar and lower limbs varicosities were prognostic factors related to incomplete treatment success. The global complication rate was low (5/113, 4.4%).


CONCLUSIONS
Transcatheter embolization was a safe and effective treatment for PCS. Lower limb symptoms, urinary urgency, and varicosities were associated with incomplete clinical success.
Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Felipe
F
Nasser
Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Interventional Radiology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: rafaelnoronha@yahoo.com.br.
Rafael N
RN
Cavalcante
Department of Interventional Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Interventional Radiology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Breno B
BB
Affonso
Department of Gynecology and Obstetrics, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Marcos L
ML
Messina
Department of Interventional Radiology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Francisco C
FC
Carnevale
Group of Research in Minimally Invasive Techniques, University of Zaragoza, Zaragoza, Spain.
Miguel A
MA
de Gregorio
D000328:Adult; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000098:blood supply; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology*; D010388:Pelvis / Q000098:blood supply; D011379:Prognosis; D012189:Retrospective Studies; D013577:Syndrome; D016896:Treatment Outcome; D014648:Varicose Veins / Q000628:therapy*
Chronic pelvic pain; Embolization; Pelvic congestion syndrome; Pelvic vein embolization