Document Detail


Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain.
MedLine Citation:
PMID:  11830623     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2002-02-06     Completed Date:  2002-05-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  171-8     Citation Subset:  IM    
Affiliation:
Interventional Radiology Division, The George Washington University, Washington, DC 20037, USA. radacv@gwumc.edu
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MeSH Terms
Descriptor/Qualifier:
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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