Introduction

Ovarian vein insufficiency (ovarian varices) is a condition that occurs with the abnormal enlargement of the veins around the uterus and ovaries. This enlargement is usually seen in the pelvic region, similar to varicose veins, but may not be visible externally. Ovarian varices are commonly observed in women who have had multiple pregnancies and are usually diagnosed with color Doppler ultrasonography or computed tomography.

While these varices do not cause any symptoms in some individuals, they can lead to uncomfortable symptoms such as pain, burning sensation, and a feeling of fullness in the lower abdomen in others. These symptoms indicate that ovarian varices can lead to pelvic congestion syndrome (PCS).

What is Ovarian Vein Insufficiency (Ovarian Varices)?

Ovarian varices are characterized by the enlargement of the veins around the uterus. Varices are enlarged and dysfunctional veins. Similar to varicose veins in the legs, ovarian varices occur with the enlargement of the vessels in the pelvic region, but this enlargement is usually not observable externally.

Symptoms

The main symptoms that ovarian varices can cause are:

• Lower Abdominal Pain: The most common symptom, usually manifesting as a chronic pain that can last for weeks or months. The pain typically intensifies before menstruation, after prolonged standing, or as a result of fatigue. Pain may also occur during and after sexual intercourse.
• Feeling of Fullness and Heaviness in the Lower Abdomen: This sensation can often be uncomfortable in the lower abdominal region.
• Varicose Veins in the Genital Area or Hips: May be seen in the groin or upper thigh areas.
• Abnormal Menstrual Bleeding and Painful Periods: Abnormal bleeding and pain may occur during menstruation.
• Pain Upon Palpation of the Lower Abdomen: Tenderness may be felt when the lower abdomen is touched, associated with ovarian varices.

What is Pelvic Congestion Syndrome (PCS)?

Pelvic congestion syndrome is a condition characterized by the enlargement and formation of varices in the veins around the uterus due to valvular insufficiency in the ovarian veins. This syndrome is commonly seen in women aged 20-45 who have had multiple pregnancies.

Symptoms:

• Pelvic Pain: Usually chronic, non-sharp, and varying depending on the menstrual cycle.
• Burning Sensation and Feeling of Fullness: In the lower abdomen.
• Pain During Intercourse (Dyspareunia): Pelvic congestion syndrome can cause discomfort during sexual intercourse.

Diagnostic Methods

Diagnosis of pelvic congestion syndrome is challenging but can be made with certain methods:

• Physical Examination: Evaluation of pain in the lower abdomen and other symptoms.
• Color Doppler Ultrasonography (CDUS): Used to assess blood flow and varices in the ovarian veins.
• Pelvic Venography: Provides detailed imaging of the veins around the uterus.
• Computed Tomography (CT) or Magnetic Resonance Imaging (MRI): Provides additional information about the condition of the veins.

Treatment Methods for Pelvic Congestion Syndrome

Several methods can be used in the treatment of pelvic congestion syndrome:

• Medication Therapy: Pain relievers, anti-inflammatory drugs, and other supportive treatments can be used to manage symptoms. However, medication usually provides temporary relief.
• Embolization via Angiography: One of the most effective methods for treating pelvic varices. It is a minimally invasive procedure and a preferred treatment option for pelvic congestion syndrome.

Embolization via Angiography

Procedure Process:

• Preparation and Anesthesia: The procedure is usually performed under local anesthesia. The patient is given relaxing and pain-relieving medications.
• Catheter Placement: The procedure is performed through the groin area or sometimes from the right internal jugular vein in the neck. A catheter is placed into the ovarian vein with the aid of a thin sheath.
• Imaging and Occlusion: A special contrast agent is injected through the catheter to visualize the varicose veins. Then, embolic materials (coils, glue, onyx, or foam) are injected into the varicose veins.
• Monitoring and Discharge: The procedure takes approximately 45-60 minutes, and patients are usually monitored for 2-3 hours after the procedure. Most patients can return to their normal lives within a day.

Advantages:

• Minimally Invasive: A procedure performed without the need for surgery and with small incisions.
• Low Risk: The risks of infection, wound healing problems, and other complications are low.
• Fast Recovery: Patients usually recover quickly after the procedure and can return to their normal lives.

Conclusion

Ovarian varices and pelvic congestion syndrome can be defined as the enlargement of veins in the pelvic region in women and the discomfort caused by this condition. The diagnosis and treatment of these conditions are usually performed with minimally invasive methods, and embolization is one of the most effective options among these treatment methods. Patients with pelvic congestion syndrome should consult an interventional radiology specialist and a gynecologist to evaluate appropriate treatment methods to alleviate their symptoms and improve their quality of life.

This information has been verified with medical information confirmed by specialist physician İbadat Hasanov and aims to inform individuals. In any case, the treatment plan is determined specifically for you, and this decision is meticulously evaluated by your doctors.