Dorobisz Tadeusz A, Garcarek Jerzy S, Kurcz Jacek, Korta Krzysztof, Dorobisz Andrzej T, Podgórski Przemysław, Skóra Jan, Szyber Piotr
4th Military Clinical Hospital, Wrocław, Poland.
Department of Radiology, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2017 Mar-Apr;26(2):269-276. doi: 10.17219/acem/68158.
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.
The objective of this study was to evaluate the efficacy of ovarian vein embolization ovarian as a method of the PCS treatment.
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.
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.
We consider embolization of insufficient ovarian veins an effective and safe way of treatment in a well-selected group of patients with PCS.
女性慢性盆腔疼痛（CPP）的一个被低估的原因可能是盆腔淤血综合征（PCS），其定义为卵巢和盆腔静脉静脉曲张并伴有盆腔区域慢性疼痛。这种疼痛持续超过6个月，且长时间站立、性交和月经时会加剧。该疾病构成了诊断和治疗难题，因此对临床医生来说是一项挑战。经导管卵巢静脉栓塞术可能是治疗PCS的一种安全有效的选择。
本研究的目的是评估卵巢静脉栓塞术作为一种治疗PCS方法的疗效。
2002年至2012年间，对10名诊断为PCS的女性（年龄范围：34 - 43岁；中位年龄39岁）进行了11次栓塞手术。1例患者接受了两次栓塞手术。1例患者进行了血管内栓塞和外阴静脉曲张手术剥脱的联合治疗。
术中无重大并发症。所有患者（100%）临床状况均有显著改善。该手术改善了患者的生活质量。3名女性（30%）在中期随访时有轻度症状复发。在栓塞术前抱怨性交困难的8名女性中，6例报告疼痛完全缓解，另外2例疼痛部分缓解。与痔疮相关的症状严重程度显著降低。
我们认为对选择合适的PCS患者组，栓塞功能不全的卵巢静脉是一种有效且安全的治疗方法。
