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Szary C, Wilczko-Kucharska J, Celejewski K, Łodyga M, Napierala M, Plucinska D, Swieczkowski-Feiz S, Leszczynski J, Zawadzki M, Grzela T. May Patients with Recurrent Venous Disease Benefit from Sequential Treatment More than Those without Previous Intervention? A Single-Center Retrospective Study on the Safety and Efficacy of Abdominal and Pelvic Veins Embolization in Sequential Approach. J Clin Med 2024; 13:5053. [PMID: 39274266 PMCID: PMC11396737 DOI: 10.3390/jcm13175053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 08/13/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
Background/Objective: The endovenous embolization of insufficient abdominal/pelvic veins is the preferred method of treatment. Also, it seems to be crucial in the treatment of lower limb vein insufficiency, particularly in recurrent disease. This study aimed to evaluate of pelvic vein embolization safety and its impact on the short-term outcome in the sequential treatment of venous disease. Methods: A retrospective analysis involved data from 506 female patients with venous disease involving abdominal and pelvic veins. All records were extracted from the medical database and included patient history, imaging reports as well as pre- and post-operative surveys. Results: Among the patients analyzed, 37.2% underwent some venous intervention in the past, with significant differences in symptom severity between groups. The embolization procedure revealed a high safety profile, with no serious complications. Pain during and after the procedure was generally low, with significantly lower pain scores in patients with recurrence. In patients who required left renal vein venoplasty a 1.7-fold increased risk of lumbar pain after embolization and venoplasty procedure was observed. Overall, 66.6% of patients reported improvement in pelvic symptoms and 72.1% experienced improvement in leg symptoms. The full sequential treatment protocol (abdominal, pelvic, and leg compartment) demonstrated superior outcomes in leg symptom improvement compared to embolization alone. Conclusions: Pelvic vein embolization is a safe and effective method of treatment, significantly improving both pelvic and leg symptoms, particularly in patients with a history of previous interventions in lower limb veins. Further studies are warranted to validate our findings and further refine treatment protocols.
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Affiliation(s)
| | | | - Krzysztof Celejewski
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Department of General, Endocrinological and Vascular Surgery, Central University Hospital, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Małgorzata Łodyga
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Department of Congenital Heart Diseases, National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Marcin Napierala
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | | | | | - Jerzy Leszczynski
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Department of General, Endocrinological and Vascular Surgery, Central University Hospital, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Michal Zawadzki
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Center of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Tomasz Grzela
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Center of Biostructure Research, Medical University of Warsaw, 02-004 Warsaw, Poland
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Patel SE, Chesnut SR. Relationships Among Pelvic Congestion Syndrome Pain, Daily Activities, and Quality of Life. J Obstet Gynecol Neonatal Nurs 2024; 53:416-426. [PMID: 38599242 DOI: 10.1016/j.jogn.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVE To examine women's experiences of pelvic congestion syndrome (PCS) pain. DESIGN Descriptive, cross-sectional. SETTING Online questionnaires in a Facebook PCS support group. PARTICIPANTS Convenience sample of 143 women who self-identified as being diagnosed with PCS. METHODS We recruited women through a social media support group and invited them to participate in a self-reported questionnaire. We collected demographic information and used the McGill Pain Questionnaire to elicit responses related to pain quality, pain intensity, quality of life, and satisfaction with health care. We analyzed data using descriptive statistics and correlation coefficients. RESULTS Respondents characterized their PCS pain as exhausting, stabbing, sharp, shooting, and tender. Respondents indicated that 19 of 24 daily activities increased PCS pain, whereas only 5 reduced PCS pain. Pain intensity was negatively related to the quality of life, health satisfaction, sleep, and sexual relationships. CONCLUSION Chronic pelvic pain from PCS severely affected quality of life among respondents. These findings suggest a difference in the presentation of PCS from historical pain depictions and further highlight the need to identify pain profiles to increase timely and precise diagnosis. Further research is needed to evaluate interventions to increase the quality of life for women with PCS.
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Corvino F, Giurazza F, Coppola M, Tomasello A, Coletta F, Sala C, Villani R, de Martino BM, Corvino A, Niola R. Chronic Pelvic Pain in Congestion Pelvic Syndrome: Clinical Impact and Electromyography Pelvic Floor Activity Prior to and after Endovascular Treatment. J Pers Med 2024; 14:661. [PMID: 38929881 PMCID: PMC11204993 DOI: 10.3390/jpm14060661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/22/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND This study aims to characterize the clinical impact of endovascular treatment in Chronic Pelvic Pain (CPP) patients due to Pelvic Congestion Syndrome (PCS) and to assess the diagnostic value of surface electromyography (sEMG) studies of pelvic floor musculature (PFM) in PCS patients pre- and post-endovascular treatment. Between January 2019 and July 2023, we studied consecutive patients who were referred for interventional radiology assessment and treatment to a tertiary trauma care hospital, had evidence of non-obstructive PCS from Magnetic Resonance Imaging (MRI), had sEMG of PFM and who had undergone endovascular treatment. The primary outcome was clinical, defined as a change in symptom severity after endovascular treatment. The secondary outcome was a difference in the sEMG values pre- and post-endovascular therapy. RESULTS We included 32 women (mean age 38 years). CPP was the leading symptom in 100% patients, followed by dysmenorrhea (75%) and post-coital pain (68.7%). Endovascular therapy included ovarian vein embolization in 28 patients (87.5%) and internal iliac vein embolization in only 2 patients (6.2%). After a median of 8 (range 6-10) months from endovascular treatment, 29 (90%) of patients reported an improvement of the main symptoms, and 15 (46%) were symptom-free. The sEMG values did not show a statistical difference pre- and post-PCS endovascular treatment. CONCLUSIONS Endovascular treatment appeared to be highly effective in CPP due to PCS and was associated with a low rate of complication. sEMG study could be useful in revealing alterations of PFM electrophysiology, but a difference pre- and post-embolization in PCS patients was not demonstrated.
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Affiliation(s)
- Fabio Corvino
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, 90127 Palermo, Italy
- Interventional Radiology Department, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (F.G.); (M.C.); (R.N.)
| | - Francesco Giurazza
- Interventional Radiology Department, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (F.G.); (M.C.); (R.N.)
| | - Milena Coppola
- Interventional Radiology Department, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (F.G.); (M.C.); (R.N.)
| | - Antonio Tomasello
- Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (A.T.); (F.C.); (C.S.); (R.V.)
| | - Francesco Coletta
- Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (A.T.); (F.C.); (C.S.); (R.V.)
| | - Crescenzo Sala
- Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (A.T.); (F.C.); (C.S.); (R.V.)
| | - Romolo Villani
- Emergency and Acceptance Department, Anesthesia, Emergency and Burn Intensive Care Unit, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (A.T.); (F.C.); (C.S.); (R.V.)
| | | | - Antonio Corvino
- Medical, Movement and Wellbeing Sciences Department, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Raffaella Niola
- Interventional Radiology Department, A.O.R.N. “A. Cardarelli”, 80131 Naples, Italy; (F.G.); (M.C.); (R.N.)
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Kavallieros K, Pope T, Mantonanakis K, Tan M, Gianesini S, Lazarashvili Z, Jaworucka-Kaczorowska A, Narayanan S, Gwozdz AM, Davies AH. A scoping review of scores or grading systems for pelvic venous disorders. J Vasc Surg Venous Lymphat Disord 2024:101901. [PMID: 38677550 DOI: 10.1016/j.jvsv.2024.101901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/28/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Pelvic venous disorders (PeVD) encompass a variety of conditions linked to chronic pelvic pain in women. However, PeVD remain underdiagnosed due to the absence of universally accepted diagnostic criteria. The complexity of PeVD classifications across specialties leads to delays in treatment. This scoping review aims to fill a gap in PeVD diagnosis and management by identifying all existing scoring or grading systems to lay the foundation for standardized clinical scoring tools for PeVD. METHODS This scoping review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping reviews. Online databases were searched up to April 2023. Studies implementing a scoring or grading system for patients with confirmed or suspected PeVD were included. Scores or grading systems were classified into four main categories based on their use in the study: screening, diagnosis, measure of disease severity, and measure of response to treatment. RESULTS Of the 2976 unique records identified, 82 were reviewed in full, and 20 were included in this study. The publication dates ranged from 1984 to 2023 (median, 2018; interquartile range, 2003-2022). A total of 21 scores and/or grading systems were identified. Of these 21 scores, 10 (47.6%) were clinical scores, and 10 (47.6%) were scores based on radiological findings; one study included a score that used both clinical and radiological findings. The identified scores were used in various settings. Of the 21 scores, 2 (9.52%) were used for screening in a tertiary care setting; 3 (14.3%) were used to establish the PeVD diagnosis; 8 (38.1%) were used to assess disease severity; and 8 (38.1%) were used as measures of response to treatment. Of the eight scores assessing disease severity, four (50.0%) assessed the degree of dilatation of pelvic veins and four (50%) assessed the severity of reflux. Only three of the scores were validated. CONCLUSIONS This scoping review identified a range of scoring and grading systems for PeVD. We note a lack of a validated scoring system, both clinical and radiological, for screening and assessment of disease severity. This is an important first step in developing validated disease-specific scoring systems for patient screening, appropriate referral, assessment of symptom severity, and assessment of the response to treatment.
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Affiliation(s)
- Konstantinos Kavallieros
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Tasneem Pope
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | | | - Matthew Tan
- Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Sergio Gianesini
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | | | | | - Sriram Narayanan
- The Venus Clinic, The Harley Street Heart and Vascular Centre, Singapore, Singapore
| | - Adam M Gwozdz
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
| | - Alun H Davies
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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Kavallieros K, Pope T, Tan M, Kaur H, Gianesini S, Lazarashvili Z, Jaworucka-Kaczorowska A, Narayanan S, Gwozdz AM, Davies AH. Identification of outcomes in clinical studies for pelvic venous disorders. J Vasc Surg Venous Lymphat Disord 2024:101865. [PMID: 38452895 DOI: 10.1016/j.jvsv.2024.101865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/19/2024] [Accepted: 02/17/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE There is increasing recognition that health systems need to measure and improve the value of patient care by measuring outcomes. Chronic pelvic pain secondary to pelvic venous insufficiency can have a significant impact on the quality of life (QOL) of women affected. Despite growing recognition, pelvic venous disorders (PeVDs), an important cause of chronic pelvic pain, remain underdiagnosed. Developing a core outcome set (COS) for benchmarking care delivery enhances the standardization of care. However, there is no consensus regarding a standardized minimum set of outcomes for PeVD. We aimed to generate a list of outcomes reported in previous PeVD treatment studies to lay the foundation for developing a COS for PeVD. METHODS This scoping review was undertaken according to the PRISMA-ScR guidelines. Initially, screening, full-text review and extraction was conducted on studies published between 2018 and 2023. Subsequently, the search was expanded using 1-year intervals, until, over a 1-year interval, no new outcomes were recorded. Closely related outcomes were classified into domains, and domains into three core areas: disease-specific, treatment-related, and QOL-related outcomes. RESULTS Of the 1579 records identified, 51 publications were included. From these studies, 108 different outcomes were identified. The median number of outcomes per study was 8 (interquartile range, 6-13). Closely related outcomes were organized into 42 outcome domains, which were then categorized into 3 core outcome areas; 47.6% (20/42) were disease specific, 35.7% (15/42) treatment related, and 16.7% (7/42) were QOL related. Of the 51 included studies, disease-specific outcomes were identified in 96.1% of the studies (49/51), treatment-related outcomes in 94.1% (48/51), and QOL outcomes in only 13.7% (7/51). CONCLUSIONS There was significant heterogeneity in outcomes reported in PeVD studies. Most PeVD treatment studies evaluated disease-specific and treatment-related outcomes of PeVD, but few reported outcomes that measured the impact on QOL. These findings will inform the next steps in developing a COS for PeVD.
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Affiliation(s)
- Konstantinos Kavallieros
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Tasneem Pope
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Matthew Tan
- Section of Vascular Surgery, Department of Surgery and Cancer, London, UK
| | - Harmeena Kaur
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sergio Gianesini
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, MD
| | | | | | - Sriram Narayanan
- Venus Clinic and The Harley Street Heart and Vascular Centre, Singapore, Singapore
| | - Adam M Gwozdz
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.
| | - Alun H Davies
- Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
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Risner V, McColgan Y, Salazar G. Interventional Treatment of Labial Varices. Semin Intervent Radiol 2023; 40:384-388. [PMID: 37575344 PMCID: PMC10415056 DOI: 10.1055/s-0043-1771040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Labial varices are commonly seen in women with varicose veins of the pelvis. Initial management is conservative management since labial varies typically resolve, particularly in pregnant patients following delivery. Varices can be seen also in association with pelvic varices in the pelvic venous disease spectrum. Sclerotherapy is often the management. This article reviews the presentation and treatment of patients with labial varices, with a focus on interventional radiologic management.
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Affiliation(s)
- Victoria Risner
- Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
| | | | - Gloria Salazar
- Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
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Wilczko J, Szary C, Bodziony A, Celejewski K, Swieczkowski-Feiz S, Napierala M, Plucinska D, Leszczynski J, Zawadzki M, Grzela T. May the Number of Pregnancies Predict the Progression and the Outcome of Venous Disease Treatment? Diagnostics (Basel) 2023; 13:2535. [PMID: 37568897 PMCID: PMC10417260 DOI: 10.3390/diagnostics13152535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Pregnancy is a well-known risk factor for venous insufficiency. However, even nulliparous women experience venous problems. Therefore, we aimed to assess the possible associations between the number of pregnancies, veins condition and treatment outcome in women with venous disease. The retrospective assessment concerned data of 297 women with diagnosed venous insufficiency. Based on their pregnancy history, the patients' records were divided into: nulliparous women (15.5%), those after 1-2 term pregnancies (57.9%) and those after ≥3 pregnancies (26.6%). The analysis concerned data from the diagnostics of the abdominal/pelvic and leg veins and the treatment results expressed as a symptoms/satisfaction score. Most of the nulliparous women developed venous disease due to mild anatomic abnormalities of the abdominal/pelvic veins. They responded to treatment (mostly unilateral embolization) very well. In the second group, the majority of the combined venous abnormalities responded to treatment with significant improvement, even after embolization alone, although nearly two-thirds still required further leg treatment. The third group was comprised of more advanced cases; nearly 40% of them with recurrence. In order to improve their condition, three-fourths of the cases required sequential treatment in both the pelvic and leg veins compartments. In conclusion, the number of pregnancies is a potent modifying factor in the pathogenesis of venous disease, especially in multiparous women. Together with abnormal venous anatomy, it may determine the treatment outcome.
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Affiliation(s)
| | | | | | - Krzysztof Celejewski
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Center of Biostructure Research and the Department of General, Endocrinological and Vascular Surgery, Central University Hospital, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Marcin Napierala
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | | | - Jerzy Leszczynski
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Center of Biostructure Research and the Department of General, Endocrinological and Vascular Surgery, Central University Hospital, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Michal Zawadzki
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Tomasz Grzela
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Center of Biostructure Research and the Department of General, Endocrinological and Vascular Surgery, Central University Hospital, Medical University of Warsaw, 02-091 Warsaw, Poland
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Szary C, Wilczko J, Bodziony A, Celejewski K, Swieczkowski-Feiz S, Napierala M, Plucinska D, Zawadzki M, Leszczynski J, Grzela T. Does the Treatment of Pelvic Venous Insufficiency Really Not Influence Lower Limb Venous Disease? Diagnostics (Basel) 2023; 13:2467. [PMID: 37568835 PMCID: PMC10416966 DOI: 10.3390/diagnostics13152467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Pelvic venous insufficiency is a common problem in multiparous women. Besides burdensome symptoms, it correlates with the development of venous disease in the lower limbs. Therefore, the sequential treatment of abdominal/pelvic before leg veins could improve treatment effectiveness. The medical records of 243 patients with venous disease who were subjected to sequential treatment were analyzed retrospectively. The symptoms and patient satisfaction were assessed using dedicated questionnaires, both before and after treatment. Clinical effectiveness was verified using a Doppler scan, both before and after treatment. Among 243 analyzed cases, 195 underwent whole treatment; however, 48 women after embolization did not require further intervention. The total-symptom-score change (11.6 vs. 13.0, respectively) and the satisfaction score (1.6 vs. 1.5, respectively) did not differ between groups. After embolization, some patients, besides symptoms improvement, experienced reflux reduction and, hence, might avoid further intervention. A better explanation for this beneficial effect of the sequential/descending approach requires further studies.
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Affiliation(s)
| | | | | | - Krzysztof Celejewski
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Medical University of Warsaw, 02-097 Warsaw, Poland
| | | | | | | | - Michal Zawadzki
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Centre of Postgraduate Medical Education, 01-828 Warsaw, Poland
| | - Jerzy Leszczynski
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Tomasz Grzela
- Clinic of Phlebology, 02-034 Warsaw, Poland
- Medical University of Warsaw, 02-097 Warsaw, Poland
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Matei SC, Dumitru CȘ, Oprițoiu AI, Marian L, Murariu MS, Olariu S. Female Gonadal Venous Insufficiency in a Clinical Presentation Which Suggested an Acute Abdomen-A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050884. [PMID: 37241116 DOI: 10.3390/medicina59050884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023]
Abstract
Pelvic venous insufficiency (PVI) is frequently associated with symptoms of abdominal pain or discomfort that is overlooked or under-diagnosed in women. Despite the fact that pelvic venous insufficiency in men is very well documented, its occurrence in women needs to be further studied. Patients with pelvic varicose veins undergo a long and inconclusive diagnostic work-up before the exact cause of the symptoms is identified. Gonadal venous insufficiency (GVI) is a condition that can present acutely, leading to diagnostic challenges. We present a case report of a 47-year-old female with acute abdominal pain and GVI, where endovascular embolization was used for successful treatment. The patient was diagnosed with GVI based on imaging findings of an enlarged left ovarian vein with retrograde flow and dilated pelvic veins seen on magnetic resonance imaging (MRI) with contrast material. Due to the severity of her symptoms and imaging findings, endovascular embolization was chosen as the treatment modality. The embolization was successful, and the patient's symptoms resolved completely. This case highlights the challenge of diagnosing GVI with acute clinical expression and the potential benefits of endovascular embolization as a treatment option. Further studies are needed to determine the optimal management strategies for acute GVI, but endovascular embolization should be considered a safe and effective option. At the same time, we present a short review of the recent literature data related to this topic.
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Affiliation(s)
- Sergiu-Ciprian Matei
- Abdominal Surgery and Phlebology Research Center, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
- 1st Surgical Clinic, "Pius Brînzeu" Emergency County Hospital, Liviu Rebreanu Boulevard No. 156, 300723 Timișoara, Romania
| | - Cristina Ștefania Dumitru
- Department of Microscopic Morphology/Histology, Angiogenesis Research Center, "Victor Babes" University of Medicine and Pharmacy, Sq. Eftimie Murgu No. 2, 300041 Timișoara, Romania
| | - Andrei-Ion Oprițoiu
- 1st Surgical Clinic, "Pius Brînzeu" Emergency County Hospital, Liviu Rebreanu Boulevard No. 156, 300723 Timișoara, Romania
| | - Lucian Marian
- Urology Clinic, "Pius Brînzeu" Emergency County Hospital, Liviu Rebreanu Boulevard No. 156, 300723 Timișoara, Romania
| | - Marius-Sorin Murariu
- Abdominal Surgery and Phlebology Research Center, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
- 1st Surgical Clinic, "Pius Brînzeu" Emergency County Hospital, Liviu Rebreanu Boulevard No. 156, 300723 Timișoara, Romania
| | - Sorin Olariu
- Abdominal Surgery and Phlebology Research Center, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timișoara, Romania
- 1st Surgical Clinic, "Pius Brînzeu" Emergency County Hospital, Liviu Rebreanu Boulevard No. 156, 300723 Timișoara, Romania
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