TRANSCATHETER EMBOLOTHERAPY FOR THE TREATMENT OF PELVIC CONGESTION SYNDROME

Background: Both medical and surgical treatments have been used for pe lvic congestion syndrome. An analogous condition in males, varicocele testis, has been treated successfully for many years by transcatheter embolotherapy. Cases: We performed percutaneous transcatheter emboliza tion of the ovarian veins in three women with chronic pelvic pain and venographically demonstrated pelvic venous congestion. In all three ca ses, the ovarian veins were embolized bilaterally from the femoral app roach, using stainless-steel coils. After the treatment, all subjects experienced a dramatic decrease in pelvic pain, as well as an improvem ent in two or more preexisting symptoms, including extremity swelling, dyspareunia, external varicosities, constipation, and emotional distu rbance. One patient's symptoms recurred at 1.2 years and required surg ery; the other two continue to have long-term benefit. Conclusion: The se findings suggest that pelvic venous congestion was the likely etiol ogic factor in pelvic pain experienced by these women and that transca theter ovarian vein embolotherapy may be an effective treatment for su ch a condition.