Gandini Roberto, Chiocchi Marcello, Konda Daniel, Pampana Enrico, Fabiano Sebastiano, Simonetti Giovanni
Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome "Tor Vergata,", 81 Oxford Street, 00133, Rome, Italy.
Cardiovasc Intervent Radiol. 2008 Jul-Aug;31(4):778-84. doi: 10.1007/s00270-007-9264-6. Epub 2008 Jan 3.
To evaluate the efficacy of transcatheter foam sclerotherapy (TCFS) in pelvic varicocele using sodium-tetradecyl-sulfate foam (STSF), we conducted a retrospective study in 38 patients (mean age, 36.9 years; range, 22-44 years) with pelvic congestion syndrome (PCS) treated between January 2000 and June 2005 by TCFS. Pelvic pain was associated with dyspareunia in 23 (60.5%) patients, urinary urgency in 9 (23.7%) patients, and worsening of pain during menstruation and at the end of a day of work in 7 (18.4%) and 38 (100%) patients, respectively. Diagnosis was made by pelvic and transvaginal color Doppler ultrasound examination, demonstrating ovarian or pelvic varices with a diameter >5 mm presenting venous reflux. TCFS was performed in all patients, using 3% STSF. Follow-up was performed by physical examination, pelvic and transvaginal Doppler ultrasound examination and by a questionnaire-based assessment of pain at 1, 3, 6, and 12 months after the procedure. Technical success was achieved in all patients (100%). In three patients a pelvic colic-like pain occurred immediately after sclerotic agent injection, disappearing spontaneously after a few minutes. No recurrent varicoceles were observed during a 12-month follow-up. A statistically significant improvement in each category of specific symptoms was observed at 1, 3, 6, and 12 months after the procedure. We conclude that TCFS of female varicocele using a 3% STSF is safe and effective for the treatment of PCS. It is associated with a significant reduction of symptoms and can be regarded as a valid alternative to other endovascular and surgical techniques.
为了评估使用十四烷基硫酸钠泡沫（STSF）的经导管泡沫硬化疗法（TCFS）治疗盆腔静脉曲张的疗效，我们对2000年1月至2005年6月间接受TCFS治疗的38例盆腔充血综合征（PCS）患者（平均年龄36.9岁；范围22 - 44岁）进行了一项回顾性研究。23例（60.5%）患者的盆腔疼痛与性交困难相关，9例（23.7%）患者有尿急症状，7例（18.4%）患者在月经期间疼痛加重，38例（100%）患者在一天工作结束时疼痛加重。通过盆腔和经阴道彩色多普勒超声检查进行诊断，显示直径>5 mm的卵巢或盆腔静脉曲张伴有静脉反流。所有患者均使用3%的STSF进行TCFS治疗。术后1、3、6和12个月通过体格检查、盆腔和经阴道多普勒超声检查以及基于问卷的疼痛评估进行随访。所有患者（100%）均获得技术成功。3例患者在注射硬化剂后立即出现盆腔绞痛样疼痛，几分钟后自行消失。在12个月的随访中未观察到复发性静脉曲张。术后1、3、6和12个月，各特定症状类别均有统计学意义的改善。我们得出结论，使用3%的STSF进行女性静脉曲张的TCFS治疗PCS是安全有效的。它与症状的显著减轻相关，可被视为其他血管内和手术技术的有效替代方法。
