Role of Trans-Catheter Ovarian Vein Embolization in the Management of Symptomatic Chronic Pelvic Congestion in Females

El-Galil, Mai Shaaban Abd; Bassiouny, Ahmed; El-Tawab, Karim Ahmed Abd; Moursy, Hossam Abd El-Kader

doi:10.12816/0039053

Cited by 1 publication

(1 citation statement)

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“…To date, there has yet to be randomized or high-quality placebo-controlled trials although studies comparing different forms of embolization exist [7], [22]. Studies report between 47%-100% of patients experience significant symptom relief 18 months to 5 years post-treatment [23]- [27]. Despite the high variability of results, transcatheter embolization during diagnostic contrast venography remains the most reliable treatment.…”

Section: Introductionmentioning

confidence: 99%

Symptoms-Based Clinical Algorithm for the Diagnosis and Treatment of Pelvic Congestion Syndrome

Cusimano¹,

Ciuffo²,

Czarnik³

et al. 2023

Preprint

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Background: Symptomatic Pelvic Congestion Syndrome (PCS) is often underdiagnosed and undertreated. We investigate a symptoms-based screening algorithm and treatment algorithm focused on position and location of pain for each type of PCS. Methods: This study is a retrospective, single-institution, multi-site review of 343 female patients who presented with pelvic pain. Results: Following a symptoms-based algorithm, 302 patients fulfilled criteria for inclusion; 299 patients had positional symptoms with a positive predictive value (PPV) of 97.99%, sensitivity of 98.99% and Odds Ratio (OR) of 48.83 (p=0.0003) while duplex ultrasonography (DUS) had a PPV of 98.84%, sensitivity of 86.49%, and OR of 6.4 (p=0.0396) confirmed by contrast venography. Patients with Type I PCS were treated with embolization and 87.5% reported total relief of anterior symptoms. Patients with Type II PCS were treated with embolization and/or vascular stenting based on their associated lesion, May-Thurner syndrome or Nutcracker syndrome, and 88.54% reported ≥50% symptom relief and 59.03% reported ≥80% symptom relief. Full treatment resulted in a mean “overall satisfaction” score of 96.07%. Conclusions: Algorithmic approaches are essential for PCS evaluation, diagnosis, and treatment. Patients with positional pelvic symptoms consistent with PCS should undergo diagnostic venography. Distinguishing between the types of PCS and using symptoms as a guide may be beneficial over a “one-size-fits-all” approach.

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