Ovarian Vein Embolization (OVE) for Pelvic Congestion Syndrome

Ovarian Vein Embolization (OVE) for Pelvic Congestion Syndrome

What are the symptoms?
Dull, aching pain is usually felt in the lower abdomen and lower back. You may experience:
• Deep pelvic pain when sitting or standing, worsening throughout the day
• Bulging veins on the vulva,
buttocks or thighs
• Painful/irregular menstrual cycles
• Pain during/after intercourse
• Irritable bladder

Who’s at Risk?
• Women less than 45 years old
• Women in their childbearing years
• Women who have had two or more pregnancies
• Women with hormonal dysfunction
• Women with polycystic ovaries

What is Pelvic Congestion Syndrome?
Pelvic congestion syndrome, also known as ovarian vein reflux, is the second leading cause of chronic pelvic pain in women, after endometriosis, and can potentially lead to significant disability resulting from the presence of varicose veins in the pelvis. Like varicose veins in the legs, pelvic congestion syndrome is related to malfunctioning valves within the pelvic veins. Valves in these pelvic veins normally allow blood to flow towards your heart. When the veins become weakened or the valves do not close properly, the blood can flow backward toward the pelvis. Blood in the weakened pelvic veins pools, causing the veins to bulge and push against nearby structures. This can result in pain and pressure in the uterus, ovaries, vulva and back. It is described as “non-cyclic” pain lasting greater than six months in duration. Diagnosis of the condition is done through one of several methods including; pelvic venography, magnetic resonance imaging (MRI) and pelvic and transvaginal ultrasound.

Chronic pelvic pain is very common in women and can potentially lead to significant disability. Approximately one out of every three women will suffer from pelvic pain at some point during their lifetime.

Diagnosing Pelvic Congestion:
The diagnosis is often missed because women lie down for a pelvic exam. This relieves pressure from the ovarian veins, so that the veins no longer bulge with blood, as they do while the woman is standing. Once other abnormalities or inflammation has been ruled out by a thorough pelvic exam, pelvic congestion syndrome can be diagnosed through several minimally invasive methods. These methods include MRI, pelvic ultrasound or transvaginal ultrasound.

What is Ovarian Vein Embolization?
Ovarian vein embolization (OVE) is a minimally invasive treatment for pelvic congestion syndrome that is used to close off faulty veins so they can no longer enlarge with blood, thus relieving the pain.
During this procedure, the physicians inserts a catheter into the jugular vein down into the faulty vein(s). Catheterization requires only a small nick in the skin for insertion and x-ray image guidance of the catheter to its target area. The catheter delivers Dacron filaments-bearing coils that clot the blood and seal the faulty vein. The use of the recently developed Sotradecol foam agent allows the physicians to block even the smallest veins not previously accessible. The sealed off veins decompress and provide relief of pressure and painful symptoms.

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