Ovarian Vein Diameter Cannot Be Used as an Indicator of Ovarian Venous Reflux

Santos, Scott J Dos; Holdstock, Judy M; Harrison, Charmaine C; Lopez, Anthony; Whiteley, Mark S

doi:10.1016/j.ejvs.2014.10.013

Cited by 57 publications

(45 citation statements)

References 24 publications

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“…17 Slow flow, inflammation, thrombosis, and insufficiency are thought to be responsible for symptom development as pelvic varices can be present in asymptomatic individuals. 7,[22][23][24][25] Factors affecting the diagnosis of PCS include variance of causes and clinical presentations of pelvic pain 1,2,20,26,27 and relatively low sensitivity of noninvasive diagnostic imaging and laparoscopy 6,22 to identify insufficiency compared with catheter venogram. Despite diagnostic challenges, studies show promising results for percutaneous management of PCS delineating it as a treatable syndrome of significant prevalence, morbidity, and systemic costs.…”

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confidence: 99%

Pelvic Congestion Syndrome: Systematic Review of Treatment Success

Brown¹,

Rizer

Alexander

et al. 2018

Semin intervent Radiol

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Pelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the United States and up to 43.4% worldwide. In addition to individual physical, emotional, and quality-of-life implications of CPP, there are profound healthcare and socioeconomic expenses with estimated annual direct and indirect costs in the United States in excess of 39 billion dollars. PCS consists of clinical symptoms with concomitant anatomic and physiologic abnormalities originating in venous insufficiency. The etiology of PCS is diverse involving both mechanical and hormonal factors contributing to venous dilatation (>5 mm) and insufficiency. Factors affecting the diagnosis of PCS include variance of causes and clinical presentations of pelvic pain and relatively low sensitivity of noninvasive diagnostic imaging and laparoscopy to identify insufficiency compared with catheter venogram. A systematic review of the literature evaluating patient outcomes following percutaneous treatment of PCS is presented.

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confidence: 99%

Pelvic Congestion Syndrome: Systematic Review of Treatment Success

Brown¹,

Rizer

Alexander

et al. 2018

Semin intervent Radiol

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“…Although there are no established criteria for the cross-sectional imaging diagnosis of PCS, relatively arbitrary diagnostic criteria are tortuous and dilated ovarian veins, reflux in ovarian veins, congested parauterine and paraovarian venous plexus, and presence of pelvic varicose veins (11,13,14). Ovarian vein dilatation with diameters greater than 8 mm on the left side and 4 mm on the right side on multidetector computed tomography (MDCT) are defined as clearly abnormal (11), but this diagnostic criterion is not universally accepted (15). There are no cross-sectional imaging studies that reported data regarding to the reference values for ovarian veins size in healthy population.…”

Section: Introductionmentioning

confidence: 99%

Ovarian vein diameters measured by MDCT in women without evidence of pelvic congestion syndrome

Aikimbaev¹,

Ballı²,

Akgül³

et al. 2017

HVT

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Abstract:Objectives: The purpose of this study was to clarify reference values for ovarian veins diameters in women without evidence of primary or secondary pelvic venous insufficiency and to determine factors influencing these parameters. Methods: Multidetector computed tomography images and medical records of 197 women were retrospectively reviewed. The patients' age, body mass index and history of parturition were examined. Results: Diameters of right ovarian veins (ROV) and left ovarian veins (LOV) ranged from one to six mm (mean 2.9 (1.0) mm, 3.2 (1.2) mm, respectively). The reference values for ROVs diameters were between 0.9 mm and 4.9 mm (95% CI 2.7-3.0 mm), while the reference values for LOVs diameters ranged from 0.8 mm to 5.5 mm (95% CI 3.0-3.3 mm). ROV diameter was significantly narrower than LOV diameter (2.9 (1.0) vs 3.2 (1.2) mm, p=0.031). Ovarian veins diameters were smaller in elderly patients (p=0.001 and p=0.002), and larger in nulliparous women (p=0.002) and those with higher individual frequency of parturition (p=0.05). There was a tendency to higher values of veins size in presence of drainage variation. Multiple regression analysis revealed presence of negative significant relationship of ROV size with age, positive association with parturition frequency and anatomical drainage variation of ovarian veins. ROVs and LOVs diameters did not differ in subgroups of normal weight, overweight and obese patients (p>0.05). Conclusions:The present study demonstrated significant reduction of ovarian veins diameters with advancement in age of patients, while increased ovarian veins diameters were related positively to parturition history and higher parturition frequency index. There was a negative relationship of right ovarian veins size with age, and positive association with parturition frequency and drainage variation. Only individual parturition frequency had an independent association with left ovarian vein diameter.

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“…No symptoms of pelvic congestion syndrome (PCS) were observed in Group 2 patients in spite of the pathological reflux blood flow along the gonadal (25%) and uterine (41.6%) veins. The diameter of intrapelvic veins was ignored, because there was no significant correlation with the presence and severity of VPP as confirmed by previous studies [14,15]. Statistically significant intergroup differences were observed for the laboratory results.…”

Section: Duplex Ultrasonography Datamentioning

confidence: 77%

“…The rea-sons behind the emergence of venous pelvic pain (VPP) remain unclear, and the available hemodynamic and inflammatory hypotheses cannot fully explain what causes the pain syndrome in some patients and why other patients with identical morphofunctional changes in pelvic veins do not have it [11,12,13]. As proved by earlier studies, there is no obvious relationship between the diameter of pelvic veins and the severity of VPP [14,15]. Meanwhile, the findings obtained by several authors indicate that there might be a relationship between neurogenic inflammation, hyperproduction, and increased activity of vasoactive neuropeptides and the emergence of VPP formation [16,17,18,19].…”

Section: Introductionmentioning

confidence: 99%

Calcitonin Gene-Related Peptide and Substance P As Predictors of Venous Pelvic Pain

Vasilieva

Vasiliev

et al. 2019

Acta Naturae

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The purpose of this work was to study the contents of calcitonin gene-related peptide (CGRP) and substance P (SP) in the blood plasma of patients with pelvic varicose veins. Thirty women with pelvic varicosities and a reflux blood flow were investigated using duplex ultrasonography. Group 1 included 18 patients with clinical signs of the pelvic congestion syndrome (PCS), including venous pelvic pain (VPP). Group 2 consisted of 12 patients with pelvic varicosities with no clinical signs of PCS. Group 1. The score of VPP intensity ranged from 4 to 8; the mean score being 4.84 0.43. The CGRP level in the studied group ranged from 0.39 to 1.01 ng/mL; the SP level ranged from 0.005 to 1.33 ng/mL. Group 2. The CGRP values were 0.15-0.32 ng/mL, and the SP range was 0.003-0.3 ng/mL. In this group, the levels of the studied peptides were 3-5 times lower than those for the patients with VPP. Group 3. The mean CGRP values were 0.06 0.003 ng/mL, and the mean SP values were 0.03 0.001 ng/mL. These values were considered as the reference parameters; a statistical analysis was performed for them. The correlation analysis revealed a strong relationship between the CGRP and VPP levels (r = 0.82) and a medium correlation between the SP level and pelvic pain in Group 1. The CGRP and SP levels in blood plasma highly correlate with the presence of pelvic venous pain.

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Ovarian Vein Diameter Cannot Be Used as an Indicator of Ovarian Venous Reflux

Abstract: There is no significant difference between the diameters of competent and refluxing ovarian veins and, as such, techniques that measure vein diameter may not be suitable for the diagnosis of venous reflux in the ovarian veins.

Cited by 57 publications

References 24 publications

Pelvic Congestion Syndrome: Systematic Review of Treatment Success

Pelvic Congestion Syndrome: Systematic Review of Treatment Success

Ovarian vein diameters measured by MDCT in women without evidence of pelvic congestion syndrome

Calcitonin Gene-Related Peptide and Substance P As Predictors of Venous Pelvic Pain

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