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Re: GYN: pelvic congestion syndrome againFrom: art fougner, md (evsono@pipeline.com)Thu Feb 5 08:00:54 1998
At Tue, 3 Feb 1998, RCSH@aol.com wrote: >
> hope this helps. 7 citations found Other Formats: Order this document Acta Radiol 1997 Nov;38(6):1023-1025 Pelvic pain syndrome caused by ovarian varices. Treatment by transcatheter embolization. Tarazov PG, Prozorovskij KV, Ryzhkov VK Division of Angio/Interventional Radiology, St Petersburg Research Institute of Roentgenology and Radiation Therapy, Russia. PURPOSE: The aim of this study was to evaluate the clinical effect of therapeutic embolization in the pelvic congestion syndrome caused by ovarian varices. MATERIAL AND METHODS: Six women, aged 25-40 years, with pelvic pain syndrome and marked left (n = 5) or bilateral (n = 1) ovarian varicocele were treated by transcatheter retrograde venous embolization. RESULTS: The pelvic pain syndrome disappeared in all patients within 4 weeks, and there was regression of the periodic pain in 2 women with dysmenorrhoea. The patients were free of symptoms during the 1-4-year follow-up. CONCLUSION: Marked ovarian varices may cause a pelvic pain syndrome. Percutaneous embolization improves both the chronic pain and the dysmenorrhea in these patients. Transcatheter treatment could be considered as an alternative to surgical or laparoscopic ligation in ovarian varicocele. PMID: 9394662, UI: 98056644 Other Formats: Links: Order this document Cardiovasc Intervent Radiol 1997 Mar;20(2):107-111 Treatment of symptomatic pelvic varices by ovarian vein embolization. Capasso P, Simons C, Trotteur G, Dondelinger RF, Henroteaux D, Gaspard U Department of Medical Imaging, University Hospital Sart Tilman, B-4000 Liege, Belgium. PURPOSE: Pelvic congestion syndrome is a common cause of chronic pelvic pain in women and its association with venous congestion has been described in the literature. We evaluated the potential benefits of lumbo-ovarian vein embolization in the treatment of lower abdominal pain in patients presenting with pelvic varicosities. METHODS: Nineteen patients were treated. There were 13 unilateral embolizations, 6 initial bilateral treatments and 5 treated recurrences (a total of 30 procedures). All embolizations were performed with either enbucrilate and/or macrocoils, and there was an average clinical and Doppler duplex follow-up of 15.4 months. RESULTS: The initial technical success rate was 96.7%. There were no immediate or long-term complications. Variable symptomatic relief was observed in 73.7% of cases with complete responses in 57.9%. All 8 patients who had partial or no pain relief complained of dyspareunia. The direct relationship between varices and chronic pelvic pain was difficult to ascertain in a significant number of clinical failures. CONCLUSION: Transcatheter embolization of lumbo-ovarian varices is a safe technique offering symptomatic relief of pelvic pain in the majority of cases. The presence of dyspareunia seemed to be a poor prognostic factor, indicating that other causes of pelvic pain may coexist with pelvic varicosities. PMID: 9030500, UI: 97184088 Other Formats: Links: Order this document Am Surg 1995 Nov;61(11):1016-1018 Pelvic congestion syndrome: a new approach to an unusual problem. Mathis BV, Miller JS, Lukens ML, Paluzzi MW Keesler Air Force Base, Mississippi 39534-2527, USA. Pelvic congestion syndrome (PCS) is an uncommon and frequently overlooked cause of debilitating pelvic pain. The well-described clinical presentation is that of pain and fullness exacerbated by prolonged standing, coitus, and in the premenstrual period in multiparus women. Physical signs include vulvar varices that can communicate with the saphenous vein in the groin, causing thigh or buttock varices. The diagnosis is usually confirmed by ovarian vein venography demonstrating reflux to the ovaries and often into the thigh with erect positioning and valsalva. Standard surgical treatment is bilateral ovarian vein ligation and excision or ligation of as many collaterals as possible. The traditional approach is bilateral retroperitoneal incisions, with medial rotation of the viscera. We report the first patient managed transperitoneally using minimally invasive techniques. Our case suggests that this approach can easily and safely be performed by surgeons experienced in laparoscopic surgery with the advantages of improved cosmesis, less postoperative pain, and rapid convalescence typical of other minimally invasive procedures. Additionally, it provides the opportunity to perform diagnostic laparoscopy as well. PMID: 7486415, UI: 96029568 Other Formats: Links: Order this document Rev Fr Gynecol Obstet 1995 Feb;90(2):84-90 [Congestive pelvic syndromes]. [Article in French] Charles G Clinique gynecologique et obstetricale, Hopital Begin, Saint-Mande. Pelvic congestion syndrome is encountered in three pathological situations: premenstrual syndrome, intermenstrual syndrome, chronic pelvic congestion syndrome. The first two syndromes, with a range of physical and/or psychological symptoms, are cyclical. Their pathogenesis is multifactorial. Hormonal and circulatory factors are essentially blamed. Treatment is most often based upon combinations of progestogens and venotonics. The third syndrome, that of chronic pelvic congestion, is characterised by long term pelvic pain and raises etiopathogenic problems which remain only partially solved and in which a vascular role may sometimes be recognised. Endovaginal ultrasonography with colour-coded Doppler and celioscopy sometimes reveal pelvic varicose veins and indicate their responsibility for such pain, after having eliminated specific pelvic pathology (post-infectious or post-operative inflammatory sequelae of pelvic tissue, rupture of the broad ligaments, endometriosis, etc.). Treatment is above all medical, based upon hormone therapy acting upon venous receptors, venotonics which decrease the consequences of stasis, intermittent courses of anti-inflammatory agents and antibiotics when there is inflammation secondary to local infection. These various types of treatment may be combined. Surgical treatment should be restricted to certain carefully assessed cases only. Publication Types: Review Review, tutorial PMID: 7732255, UI: 95249842 Other Formats: Links: Order this document Obstet Gynecol 1994 May;83(5 Pt 2):892-896 Transcatheter embolotherapy for the treatment of pelvic congestion syndrome. Sichlau MJ, Yao JS, Vogelzang RL Department of Diagnostic Radiology, Northwestern University Medical School, Chicago, Illinois. BACKGROUND: Both medical and surgical treatments have been used for pelvic congestion syndrome. An analogous condition in males, varicocele testis, has been treated successfully for many years by transcatheter embolotherapy. CASES: We performed percutaneous transcatheter embolization of the ovarian veins in three women with chronic pelvic pain and venographically demonstrated pelvic venous congestion. In all three cases, the ovarian veins were embolized bilaterally from the femoral approach, using stainless-steel coils. After the treatment, all subjects experienced a dramatic decrease in pelvic pain, as well as an improvement in two or more preexisting symptoms, including extremity swelling, dyspareunia, external varicosities, constipation, and emotional disturbance. One patient's symptoms recurred at 1.2 years and required surgery; the other two continue to have long-term benefit. CONCLUSION: These findings suggest that pelvic venous congestion was the likely etiologic factor in pelvic pain experienced by these women and that transcatheter ovarian vein embolotherapy may be an effective treatment for such a condition. PMID: 8159389, UI: 94211460 Other Formats: Links: Order this document Br J Hosp Med 1990 Jul;44(1):14 Pelvic congestion syndrome and ligation of ovarian veins. Schraibman IG Publication Types: Comment Letter Comments: Comment on: Br J Hosp Med 1990 Mar;43(3):200-6 PMID: 2397331, UI: 90374030 Other Formats: Links: Order this document Br J Hosp Med 1990 Mar;43(3):200-206 The pelvic congestion syndrome. Hobbs JT St Mary's Hospital, London. Perivulval varices appear during pregnancy and usually disappear after delivery but become more prominent with subsequent pregnancies. They may extend over the buttock and may be associated with recurrent leg varices. Some patients have extensive varices in the broad ligaments and present with the pelvic congestion syndrome. These patients have been shown to have grossly dilated ovarian veins. Elimination of this proximal incompetence relieves the symptoms. Publication Types: Review Review, tutorial Comments: Comment in: Br J Hosp Med 1990 Jul;44(1):14 PMID: 2180521, UI: 90199351 the above reports in format documents on this page through Loansome Doc good luck art
-- art fougner, md SonoScan/Genetic Sciences forest hills, ny evsono@pipeline.com
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