Re: Ovarian Venous Insufficency
From: Dr Fazeel uz Zaman (fazeel@atd.hazara.net.pk)
Fri May 11 15:16:58 2001
Ovaries have dual blood supply.......from uterine artery and from upper abdominal
aorta. ...........so torsion may not completely occlude the supply and drainage ?
Dr. Fazeel
margie perez wrote:
> At Mon, 11 Oct 1999, Phillip Ramm wrote:
> >
> >Some interesting work was done in Wagga Wagga (where?) in Australia by
> >Dr Graeme Richardson and Trevor Beckwith on identifying ovarian vein
> >insufficiency with color Doppler ultrasound in women with pelvic
> >congestion syndrome (post-coital heaviness, etc.) The dilation of pelvic
> >varicosities reduced the venous hydrostatic pressure, preventing these
> >veins from draining properly, in concert with a failed upper level
> >ovarian vein valve, disrupted due to the extreme distension associated
> >with previous pregancy(ies). Being a vascular surgeon, Dr Richardson
> >tied off the offending incompetent veins with apparantly good results.
> >Problems with previous radiological embolisation were felt to be due to
> >the great dilation possible with this vein, and results (symptom
> >resolution) therefore were poor and the technique was pretty much
> >abandoned. So yes apparantly there are valves in the ovarian veins, or
> >there should be, particularly the left which has a renal vein
> >termination, which makes it more prone to incompetence (somehow? more
> >blood flow?). I could not find a reference in Medline however. They
> >used this pathology as a direct metaphor for male varicocele, although
> >the cause of failure is different - pregnacy! Perhaps some congenital
> >weakness or absence of the gonadal vein valves is a common cause?
> >
> >The left ovarian vein can be identified passing over the iliac vessels
> >in many many patients. With some persistence, you can even identify it
> >at its termination/origin at the left renal vein. Scanning the patient
> >in the (semi-)upright position will lend gravity to the situation...
> >
> >Sorry if I have this a little wrong - I am working from the memory of a
> >paper and some hands-on scanning with Trevor from about 6 years ago.
> >
> >--
> >Phillip Ramm AMS (Accredited Medical Sonographer - Australia)
> >
> >At Sun, 10 Oct 1999, James S Smeltzer MD wrote:
> >>
> >>Michael,
> >>
> >>Does the ovarian vein have valves? It seems to me that the hydrostatic
> >>pressure in the lower abdomen would prevent this problem (except in outer
> >>space, where it would not be a problem anyway). We know from cystometric
> >>studies that the lower abdomen has a positive hydrostatic pressure, which
> >>contributes to incontinence when the VUG prolapses in anatomic SUI. The
> >>cure is to return this angle to an intraabdominal location, so the pressure
> >>is equalized.
> >>
> >>This can affect the testicular vein (varicocele) because of its
> >>extraabdominal location, and the leg veins for the same reason. The
> >>ovaries are in the coelom, so I would be interested if you could explain
> >>the physics of this hypothesized defect to me.:) Jim S.
> >>
> >>At 07:58 AM 9/28/1999 -0500, you wrote:
> >>>Does anyone have any information regarding the assessment of ovarian
> >>>venous insufficiency. Many thanks
> >>>
> >>>--
> >>>Michael S Baker
> >>>Sonographer
> >>>
>
> --
> Subject:Doppler of normal ovary vs ovarian torsion
> Please provite your comments and suggestions: I am trying to locate an articial
> covering normal ovarian doppler values. What are the correct valves to use,
> ,when pulse doppler of the ovaries is needed. Another issue is commonly,both
> ovaries do not light up during color doppler. Is this an expected normal result?
> Finally and most important to me is Ovarian Torsion. I've had the result of
> and normal ovary had no color doppler of pulse doppler. Now a torsed ovary will
> or can behave in the same manor. This can be quite perplexing.
> Thank You for assistance in this Quest of mine.
> Margie Perez, RDMS
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