| Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain. | |
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MedLine Citation:
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PMID: 11830623 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The purpose of this study was to analyze the impact of transcatheter embolotherapy on pain perception and menstrual cycle in women with chronic pelvic pain caused by the presence of ovarian and pelvic varices (ie, women with pelvic congestion syndrome or pelvic venous incompetence). MATERIALS AND METHODS: From July 1998 to August 2000, 56 patients (mean age, 32.3 y) were treated for chronic pelvic pain. Diagnostic venography of the ovarian veins was followed by transcatheter embolotherapy with a sclerosing agent and coils. A second session was completed to embolize the internal iliac veins in 43 of 56 patients. Visual analog scales (VAS) used to measure pain were administered before embolization and at 3-, 6-, and 12-month follow-up. Questionnaires regarding menstrual history were used as part of the postprocedural analysis. RESULTS: Percutaneous transcatheter embolotherapy of ovarian and pelvic varices was technically successful in 56 of 56 patients (100%); three patients developed recurrent varices, two of whom were treated with repeat transcatheter embolotherapy. Two patients, early in the experience, had complications in which coils placed in the internal iliac veins embolized to the pulmonary circulation; the coils were snared without clinical sequelae. On the VAS, the mean baseline pain level was 7.8 (range, 3.2-9.8; n = 56); at 3-month follow-up, it was 4.2 (range, 0.0-7.2; n = 56); at 6 months, 3.8 (range, 0.0-6.7; n = 41); and at 12 months, 2.7 (range, 0.0-6.9; n = 32). Differences were significant (P <.001) between baseline pain levels and those at all follow-up intervals (ie, 3, 6, and 12 months). The mean decrease in VAS was 5.1 (65% decrease). The clinical follow-up in this series ranged between 6 and 38 months; the mean was 22.1 months. Regarding the impact of embolization on menstruation, all 24 patients responding to questionnaires indicated no change in menstrual cycle. CONCLUSION: For patients with ovarian/internal iliac varices, transcatheter embolotherapy provides a nonsurgical treatment option. There is a significant decrease in pain based on VAS without any notable impact on menstrual cycle. |
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Authors:
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Anthony C Venbrux; Andrew H Chang; Hyun S Kim; Brian J Montague; Jillyn B Hebert; Aravind Arepally; Peter C Rowe; Diana F Barron; Drew Lambert; J Courtland Robinson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 13 ISSN: 1051-0443 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-02-06 Completed Date: 2002-05-14 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 171-8 Citation Subset: IM |
Affiliation:
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Interventional Radiology Division, The George Washington University, Washington, DC 20037, USA. radacv@gwumc.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Chi-Square Distribution Chronic Disease Embolization, Therapeutic* Female Humans Iliac Vein Menstrual Cycle / physiology Middle Aged Ovarian Diseases / complications, therapy* Ovary / blood supply* Pain Measurement Pelvic Pain / etiology, therapy* Pelvis / blood supply* Phlebography Syndrome Treatment Outcome Varicose Veins / therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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