The pelvic venous syndromes: Analysis of our experience with 57 patients

Scultetus, Anke; Villavicencio, J. Leonel; Gillespie, David L.; Kao, Tzu Cheg; Rich, Norman M.

doi:10.1067/mva.2002.129114

Cited by 108 publications

(78 citation statements)

References 29 publications

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“…20,21 It is important to emphasize the presence of collateralization of tributaries into the posterior aspect of the thigh through recanalization of the ischiatic primitive system, as well as transference of the reflux to the saphenous vein system in the presence of ostial competence of the saphenofemoral junction. These findings are extremely relevant because they allow to focus treatment planning on the real source of reflux.…”

Section: (158%) But Lower When Compared To the Study By Labropoulosmentioning

confidence: 99%

Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography

Barros¹,

Perez

Zandonade

et al. 2010

J. vasc. bras.

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Introduction: Pelvic varicose veins, one of the main causes of chronic pelvic pain and dyspareunia, are an important source of reflux for lower limb varicose veins, especially in recurrent cases. Color Doppler ultrasound of the lower limbs and transvaginal ultrasound are the noninvasive diagnostic methods most commonly used to assess pelvic venous insufficiency, whereas phlebography is still considered as the gold standard. Objectives: To determine the prevalence of lower limb varicose veins originating from the pelvis in a group of female patients and to determine the agreement between results obtained via color Doppler ultrasound of the lower limbs, transvaginal ultrasound, and phlebography. Methods: The sample comprised female patients referred to a vascular laboratory for lower limb screening. Patients diagnosed with deep venous thrombosis were excluded. Data analysis included kappa coefficient of agreement, McNemar' s test, sensitivity and specificity values. Results: Of a total of 1,020 patients, 124 (12.2%) had findings compatible with reflux of pelvic origin. Among these patients, 51 (41.2%) were recurrent cases. A total of 249 were submitted to transvaginal ultrasound. There was significant agreement between lower limb ultrasonographic findings and transvaginal findings. Phlebography was performed in 54 patients. The comparison between transvaginal ultrasound and phlebography was associated with a 96.2% sensitivity and 100% specificity. Conclusions: The authors draw attention to the relatively high prevalence of lower limb varicose veins originating from the pelvis, suggesting an important but underdiagnosed cause of recurrent varicose veins.

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Section: (158%) But Lower When Compared To the Study By Labropoulosmentioning

confidence: 99%

Evaluation of pelvic varicose veins using color Doppler ultrasound: comparison of results obtained with ultrasound of the lower limbs, transvaginal ultrasound, and phlebography

Barros¹,

Perez

Zandonade

et al. 2010

J. vasc. bras.

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“…During pregnancy, the diameter of the ovarian veins increases several fold. According to the literature, multiple pregnancies are a major factor in the pathogenesis and progression of pelvic varicosis, which is considered to be a secondary phenomenon in multiparous women (3,9).…”

Section: Discussionmentioning

confidence: 99%

Pregnancy after embolization of ovarian varicocele: report of two cases

Таразов

Prozorovskij²,

Rumiantseva³

2009

Diagn Interv Radiol

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Ovarian varicocele is a well-known cause of pelvic pain in women (1-3). Surgical or laparoscopic ligation, or retrograde transcatheter embolization is successfully used for treatment of symptomatic cases (l-6).In 1991, Galkin et al. (7) hypothesized that long-lasting ovarian varicocele might cause hypofunction of the ovaries and, similar to testicular varicocele, could be a cause of infertility. This hypothesis is not yet proven in the medical literature. We report two cases of pregnancy in women with infertility after successful transcatheter embolization of ovarian varices. Case reports Case 1A 43-year-old woman presented with chronic pelvic pain of three years duration. Her pain increased after physical activity and during menses. She had given birth to a full-term baby 20 years prior to presentation. She has not become pregnant since that time, despite a lack of contraception during the last 7 years. Repeated gynecologic examinations including hysterosalpingography did not reveal any source of pelvic pain. No disorder of hormonal milieu was noted on endocrine evaluation.Abdominal ultrasound did not reveal any gynecologic pathology such as leiomyoma, adenomyosis, or endometriosis, but it showed marked dilatation of veins around the left ovary. The diameter of the left ovarian vein trunk was 12 mm.The presence of left ovarian varicocele was confirmed by selective retrograde venography. The right transjugular approach was used, because the patient had several large moles on both groins. A Headhunter 1 catheter (Cordis, Bridgewater, New Jersey, USA) was placed in the left renal vein, and then in the left ovarian vein. Embolization of the dilated left ovarian vein was performed with three long and four short homemade steel coils 10-12 mm in diameter (Fig. 1). The right ovarian vein was not dilated.During the next month, the patient had significant reduction of pelvic pain, which eventually disappeared completely. Ultrasound (US) examination showed occlusion and fibrosis of the left ovarian vein, and disappearance of pelvic varices. Three months after the procedure, the patient became pregnant. The pregnancy was normal, and resulted in an easy delivery. Case 2A 25-year-old woman was referred to our hospital with a 4-year history of infertility. She had never been pregnant. She complained of periodic mild pelvic pain and dysmenorrhea. Her symptoms were aggravated by standing for a long time, and they increased during sexual activity. No pathological changes were observed on gynecologic examination or en- ABSTRACT We describe two cases of left-sided ovarian varicocele in patients with infertility. Pregnancy occurred in both women after successful retrograde venous embolization. Ovarian varicocele may be associated with infertility in some patients. INTERVENTIONAL RADIOLOGY

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“…В частности, рассматриваемая большинством авто ров как «эталон лечения» ТВП эндоваскулярная эм болизация гонадных вен сопровождается техниче ским успехом в 92-95% случаев, а ее клиническая эффективность колеблется от 40 до 82% [2,3]. Эф фективность внебрюшинной резекции гонадных вен в ликвидации тазовых болей при ТВП составля ет 73-95% [4,5]. Другие авторы [6] сообщают о вы сокой эффективности эндоскопической резекции гонадных вен при ТВП, достигающей 80-90%.…”

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