Skip to main content
SpringerLink
Log in

Transcatheter Foam Sclerotherapy of Symptomatic Female Varicocele with Sodium-Tetradecyl-Sulfate Foam

  • Clinical Investigation
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

To evaluate the efficacy of transcatheter foam sclerotherapy (TCFS) in pelvic varicocele using sodium-tetradecyl-sulfate foam (STSF), we conducted a retrospective study in 38 patients (mean age, 36.9 years; range, 22–44 years) with pelvic congestion syndrome (PCS) treated between January 2000 and June 2005 by TCFS. Pelvic pain was associated with dyspareunia in 23 (60.5%) patients, urinary urgency in 9 (23.7%) patients, and worsening of pain during menstruation and at the end of a day of work in 7 (18.4%) and 38 (100%) patients, respectively. Diagnosis was made by pelvic and transvaginal color Doppler ultrasound examination, demonstrating ovarian or pelvic varices with a diameter >5 mm presenting venous reflux. TCFS was performed in all patients, using 3% STSF. Follow-up was performed by physical examination, pelvic and transvaginal Doppler ultrasound examination and by a questionnaire-based assessment of pain at 1, 3, 6, and 12 months after the procedure. Technical success was achieved in all patients (100%). In three patients a pelvic colic-like pain occurred immediately after sclerotic agent injection, disappearing spontaneously after a few minutes. No recurrent varicoceles were observed during a 12-month follow-up. A statistically significant improvement in each category of specific symptoms was observed at 1, 3, 6, and 12 months after the procedure. We conclude that TCFS of female varicocele using a 3% STSF is safe and effective for the treatment of PCS. It is associated with a significant reduction of symptoms and can be regarded as a valid alternative to other endovascular and surgical techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Venbrux AC, Lambert DL (2000) Ovarian and pelvic varices in the female patient. In: Savader SJ, Trerotola SO (eds) Venous interventional radiology with clinical perspectives. 2nd ed. Thieme Medical, New York, pp 210–216

    Google Scholar 

  2. Milburn A, Reiter C, Rhomberg A (1993) Multidisciplinary approach to chronic pelvic pain. Obstet Gynecol Clin North Am 20:643–659

    PubMed  CAS  Google Scholar 

  3. Zondervan K, Yudkin P, Vessey M (2001): Chronic pelvic pain in the community–symptoms, investigations and diagnoses. Am J Obstet Gynecol 184:1149–1155

    Article  PubMed  CAS  Google Scholar 

  4. Hodgkinson CP (1953) Physiology of the ovarian veins during pregnancy. Obstet Gynecol 1:26–37

    PubMed  CAS  Google Scholar 

  5. Giacchetto C, Cotroneo GB, Marincolo F, et al. (1990) Ovarian varicocele: ultrasonic and phlebographic evaluation. J Clin Ultrasound 18:551–555

    Article  PubMed  CAS  Google Scholar 

  6. Summit RI (1993) Urogynecologic cause of chronic pelvic pain. Obstet Gynecol Clin North Am 20:685–715

    Google Scholar 

  7. Giacchetto C, Catizone F, Cotroneo GB, et al. (1990) Ovarian varicocele: ultrasonic and phlebographic evaluation. J Clin Ultrasound 18:551–553

    Article  PubMed  CAS  Google Scholar 

  8. Beard RW, Kennedy RG, Gangar KF, et al. (1991) Bilateral oophorectomy and hysterectomy in the treatment of intractable pelvic pain associated with pelvic congestion syndrome. Br J Obstet Gynecol 98:988–992

    Article  CAS  Google Scholar 

  9. Mathis B, Miller J, Lukens M (1995) Pelvic congestion syndrome: a new approach to an unusual problem. Am J Surg 61:1016–1018

    CAS  Google Scholar 

  10. Edwards RD, Robertson JR, MacLean AB, et al. (1993) Case report: pelvic pain syndrome—successful treatment of a case by ovarian vein embolization. Clin Radiol 47:429–431

    Article  PubMed  CAS  Google Scholar 

  11. Sichlau MJ, Yao JS, Vogelzang RL (1994) Transcatheter embolotherapy for the treatment of pelvic congestion syndrome. Obstet Gynecol 83:892–896

    PubMed  CAS  Google Scholar 

  12. Beard RW, Highman JH, Pearce S, et al. (1984) Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet 2:946–949

    Article  PubMed  CAS  Google Scholar 

  13. Venbrux AC, Lambert DL (1999) Embolization of the ovarian veins as a treatment for patients with chronic pelvic pain caused by pelvic venous incompetence (pelvic congestion syndrome). Curr Opin Obstet Gynecol 11:395–399

    Article  PubMed  CAS  Google Scholar 

  14. Kwohn SH, Oh JH, Ko KR, Park HC, Huh JY (2007) Transcatheter ovarian vein embolization using coils for the treatment of pelvic congestion syndrome. CardioVasc Interv Radiol 30(4):655–661

    Article  Google Scholar 

  15. Parsonn L, Stovall TG (1993) Surgical management of chronic pelvic pain. Obst Gynecol North Am 20:765–775

    Google Scholar 

  16. Goffette P, Hammer F, Mathurin P, et al. (1995) Recurrence of varicocele after spermatic vein embolization in young patients: radiological aspect. Acta Urol Belg 63:55–56

    PubMed  CAS  Google Scholar 

  17. Tarazov PG, Prozorovskij KV, Ryzhkov VK (1997) Pelvic pain syndrome caused by ovarian varices: treatment by transcatheter embolization. Acta Radiol 38:1023–1025

    PubMed  CAS  Google Scholar 

  18. Capasso P, Simone C, Trotteur G, et al. (1997) Treatment of symptomatic pelvic varices by ovarian vein embolization. CardioVasc Interv Radiol 20:107–111

    Article  CAS  Google Scholar 

  19. Cordts PR, Eclavea A, Buckley PJ, et al. (1998) Pelvic congestion syndrome: early clinical results after transcatheter ovarian vein embolization. J Vasc Surg 28:862–868

    Article  PubMed  CAS  Google Scholar 

  20. Maleaux G, Stockx L, Wilms G, et al. (2002) Ovarian vein embolization for the treatment of pelvic congestion syndrome: long term technical and clinical results. J Vasc Interv Radiol 13:171–178

    Article  Google Scholar 

  21. Venbrux AC, Chang AH, Kim HS, et al. (2002) Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain. J Vasc Interv Radiol 13:171–178

    Article  PubMed  Google Scholar 

  22. Pieri S, Agresti P, Morucci M, et al. (2003) Percutaneous treatment of pelvic congestion syndrome. Radiol Med (Torino) 105:76–82

    Google Scholar 

  23. Bachar GN, Belenky A, Greif F, et al. (2003) Initial experience with ovarian vein embolization for the treatment of chronic pelvic pain syndrome. Isr Med Assoc J 12:843–846

    Google Scholar 

  24. Eclavea A (1998) Pelvic congestion syndrome: multicenter results. J Vasc Interv Radiol 9:184–185

    Google Scholar 

  25. Tessari L, Cavezzi A, Frullini A (2001) Preliminary experience with a new sclerosing foam in the treatment of varicose veins. Dermatol Surg 27:58–60

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome “Tor Vergata,”, 81 Oxford Street, 00133, Rome, Italy

    Roberto Gandini, Marcello Chiocchi, Daniel Konda, Enrico Pampana, Sebastiano Fabiano & Giovanni Simonetti

  2. Department of Radiology, University of Rome “Tor Vergata,”, 81 Oxford Street, 00133, Rome, Italy

    Roberto Gandini

Authors
  1. Roberto Gandini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marcello Chiocchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel Konda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Enrico Pampana
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sebastiano Fabiano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giovanni Simonetti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcello Chiocchi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gandini, R., Chiocchi, M., Konda, D. et al. Transcatheter Foam Sclerotherapy of Symptomatic Female Varicocele with Sodium-Tetradecyl-Sulfate Foam. Cardiovasc Intervent Radiol 31, 778–784 (2008). https://doi.org/10.1007/s00270-007-9264-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-007-9264-6

Keywords

Search

Navigation