Minimally invasive treatment of pelvic congestion syndrome

Complex clinical and ultrasound examination of 81 women with chronic venous insufficiency (CVI) of the pelvis was analyzed. All the patients had left-side regional renal venous hypertension which caused valvular insufficiency of the left ovarian vein with spread of the reno-ovarian blood reflux onto the pampiniform, uterovaginal, presacral, vesical and rectal plexuses. Right-side cavaovarial reflux of blood was found but in 29.6% of the patients and in combination with reno-ovarial reflux caused complete decompression of the venous outflow from the pelvis. The treatment was performed depending on the stage of CVI of the pelvis. At the stage of compensation (59.3% of patients) complex conservative treatment was used, at the stage of subcompensation (17.3%)--sclerotherapy, at the stage of decompensation (23.4%)--operative dissection of gonad veins. Excellent results were registered in 34.5%, good--in 43.2%, satisfactory--in 21%, unsatisfactory in 1.2% of the patients. On the basis of self-assessment of quality of life 77.8% of the patients thought to be completely restored, 16%--improved, 6.2% of women had no changes.