[Uterine phlebography in pelvic venous stasis].

Pelvic veins opacification is very helpful in the diagnosis of vascular pelvic pain. First applied to intrauterine vascularisation and hypoplasia research, hysterophlebography allow the venous side of stasis to be obvious. 1) Normally, a fine intra-parietal network draining in intrauterine peripheric vein (arcuate network) is patterned by the contrast medium. For that 4 vessels roots are leaving: 2 lumbo-ovarian pedicles joining uterine venous side und tubal veins and extending over lumbo-ovarian pedicle; 2 uterine pedicles resulting from 2 uterine veins and receiving vesical veins located in the base of broad ligament. Contrast medium empties very quickly and almost the whole uterus emptying is lasting less than 10 seconds. 2) From a pathological point of view: a) in stasis, intrauterine veins pattern features are: intra-parenchymatous pictures of dilated venous network, local alterations pictures often secondary to thrombosis (9/10 on the left side) with intra-parenchymatous stasis and oblique anastomatic main vessels characterizing uterine veins thrombosis, more than 20 seconds emptying delay. Hysterographic and phlebographic times take advantage to be paired by visualizing mucous lesions (hypoplasia and polyp. endocervical and corporeal) in intra-parenchymatous stasis phenomena. b) Extrauterine stasis signs are characterized by preferentially right pedicles dilatation. Standing in upright position enhances stasis (proclive radiographies at 70 degrees). Dilatation is particularly located at the base of the broad ligament and gives to uterine veins with wide smeets a flexuous feature with wide contrasted clusters. Hence here emptying is slow and belayed.