Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 2, March-April, p. 269–276

doi: 10.17219/acem/68158

Publication type: original article

Language: English

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Diagnosis and treatment of pelvic congestion syndrome: Single-centre experiences

Tadeusz A. Dorobisz1,A,B,F, Jerzy S. Garcarek2,A,B,C,E,F, Jacek Kurcz2,B,C,E,F, Krzysztof Korta3,B,C,E,F, Andrzej T. Dorobisz3,A,B,C,D,E,F, Przemysław Podgórski2,B,C, Jan Skóra3,A,B,C,E,F, Piotr Szyber3,A,B,E,F

1 4th Military Clinical Hospital, Wrocław, Poland

2 Department of Radiology, Wroclaw Medical University, Poland

3 Chair and Department of Vascular, General and Transplantation Surgery, Wroclaw Medical University, Poland

Abstract

Background. One of the underestimated causes of chronic pelvic pain (CPP) in women may be pelvic congestion syndrome (PCS) that is defined as the presence of varicose of ovarian and pelvic veins associated with chronic pain in the region of the pelvis. This pain is present longer than 6 months and intensifies with prolonged standing, coitus and menstruation. The disease constitutes a diagnostic as well as therapeutic problem, thus posing a challenge for the clinician. Transcatheter ovarian vein embolization might be a safe and effective option for PCS treatment.
Objectives. The objective of this study was to evaluate the efficacy of ovarian vein embolization ovarian as a method of the PCS treatment.
Material and Methods. Between 2002–2012, 11 embolization procedures were performed in 10 women (age range: 34–43; median age 39) with the diagnosis of PCS. One patient underwent embolization procedure twice. In 1 case the combined therapy of endovascular embolization and surgical phlebectomy of vulvar varices was performed.
Results. There were no major intrainterventional complications. In all the patients (100%) a significant improvement in the clinical status was noted. The procedure improved the quality of life in the patients. Three women (30%) had a mild recurrence of the symptoms at mid-term follow-up. Among 8 women who had complained of dyspareunia prior to embolization 6 patients reported complete pain relief, in other 2 cases the pain subsided partially. There was a significant decrease in the severity of symptoms associated with hemorrhoids.
Conclusion. We consider embolization of insufficient ovarian veins an effective and safe way of treatment in a well-selected group of patients with PCS.

Key words

chronic pelvic pain, pelvic congestion syndrome, transcatheter embolization, ovarian vein insufficiency

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