Abstract:

Article presents our experience of endovascular occlusion of gonadal veins in patients with pelvic congestion syndrome (PCS). Interventional treatment of patients with this pathology requires further research.

Aim: was to study aspects of endovascular occlusion of gonadal veins in patients with pelvic congestion syndrome.

Materials and methods: 22 patients with a primary form of pelvic congestion syndrome were included in a prospective, single-center study. The diagnosis was based on screening ultrasound duplex angioscanning. The criterion for inclusion in the study was the presence of varicose expansion of ovarian veins (OV) of more than 5 mm in combination with its valve failure. Exclusion criteria were: presence of secondary PCS against the background of obstructive syndromes, multivessel anatomy type of OV, pregnancy at any gestation age.

To assess the dynamics of manifestations of pelvic venous congestion, we used the PVVQ questionnaire (Pelvic Varicose Veins Questionnaire) and the PCS clinical severity scale - PVCSS (Pelvic Venous Clinical Severity Score), as well as the visual-analogue scale (VAS) of main symptoms of the disease.

Instrumental research methods included: ultrasound duplex transvaginal and transabdominal angioscanning (UDAS), multispiral computer phlebography (MSCT-phlebography), digital phlebography with invasive direct phlebomanometry.

Results: technical success of endovascular occlusion of ovarian veins was 100%. In two cases, immediately after the operation, a second intervention was performed: in one case - resection of the ovarian vein, in the second - re-positioning of the microspiral. In the long-term follow-up period, in one of the women due to relapse, the ovarian vein occlusion procedure was repeated.

Conclusions: estimation of results of clinical research methods, showed a decrease in the intensity of manifestations of pelvic congestion syndrome basing on severity scale and a visual-analogue scale, as well as an improvement in the quality of life of patients.

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