Evaluation of transcatheter foam sclerotherapy in the treatment of pelvic and atypical lower limb varicosities

Abstract

Introduction Chronic pelvic pain is a widely prevalent symptom ranging from mild to severe disabling intensity. Pelvic venous insufficiency is one of the causes of chronic pelvic pain, especially in females of child-bearing age. Embolotherapy is now a developing-adopted treatment method to pelvic venous insufficiency. Patients and methods We accomplished a prospective study on 20 females (mean age, 33.8 years; range between 20 and 45 years) with pelvic congestion syndrome treated between April 2017 and April 2018 by Trans-Cutaneus Foam Sclero- therapy (TCFS). Pelvic pain and atypical lower limb varices were associated with dyspareunia in 16 (80%) patients, urinary urgency in 12 (60%) patients, and tender ovarian point sign in 17 (70%) patients. Diagnosis depended mainly on pelvic pain analysis, detailed history taking, and clinical examination and was confirmed by transcatheter venographic findings. TCFS by 5% ethanolamine oleate was performed in all patients. Follow-up was done by estimation of pain at 1, 3, 6, and 12 months after the maneuver. Results The percentage of technical success was 100%. A statistically significant clinical improvement in each category of specific symptoms was noticed at 1, 3, 6, and 12 months after the procedure. Recurrence was observed in one case. Minor adverse effects were noticed after the procedure, and they were mild and responsive to medical treatment. Conclusion We found out that TCFS of female varicocele using a 5% ethanolamine is safe and effective to treat pelvic congestion syndrome. It is accompanied by a considerable reduction of symptoms and can be regarded as a proper alternative to other medical and surgical techniques.