Endoscopic Technologies for the Diagnostics and Treatment of Pelvic Congestion Syndrome

Сажин, А. В.; Sg, Gavrilov; Temirbolatov, M. D.

doi:10.17116/flebo2017113146-153

Cited by 12 publications

(4 citation statements)

References 12 publications

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“…The indications for GVE and GVR were presence of clinical signs of PeVD (pelvic pain, feeling of heaviness and discomfort in the hypogastric region during static or physical loads, dyspareunia, and dysuria), pathological reflux in the GV with the valvular incompetence of the parametrial and uterine veins according to transvaginal and transabdominal DUS, and the absence of nutcracker or May-Thurner syndromes according to DUS, renal venography, and multiplanar pelvic venography. 14,17 In most cases (71%), the GVE was performed as the least traumatic method. The main criterion in the choice of procedure to reduce blood flow in the dilated GV was their diameter: GVE was preferred in case the GV diameter was less than 10 mm, otherwise, GVR was performed.…”

Section: Methodsmentioning

confidence: 99%

Use of a novel Likert scale instrument to assess patient satisfaction following endovascular and surgical treatment of pelvic venous disorders

Grishenkova

Mishakina

et al. 2022

Phlebology

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Objective The study was aimed at assessing satisfaction with endovascular and surgical treatment, using a novel Likert scale procedure satisfaction instrument, in patients with pelvic venous disorder (PeVD) caused by the gonadal vein reflux. Methods This prospective cohort study included 100 women with PeVD who underwent gonadal veins embolization with coils (GVE group, n = 71) or gonadal veins endoscopic resection (GVR group, n = 29) in 2012–2020. The GVE was performed under local anesthesia and sedation, and was left-sided in 61, right-sided in three, and bilateral in seven patients. The GVR was performed under general anesthesia through transperitoneal ( n = 19) or retroperitoneal ( n = 10) access with three access ports in both cases. The GVR was left-sided in 19, right-sided in one, and bilateral in nine patients. To assess satisfaction with GVE and GVR treatment of PeVD, patients were asked to evaluate statements related to their experience using a new Likert scale instrument. The responses for each item were compared between the groups at Day 7 (D7) and at Month 6 (M6) after the procedure, as was a summary score of all the responses at both time points. The summary score allowed categorization on a spectrum from “completely satisfied” to “completely dissatisfied.” Results The comparison between GVЕ and GVR groups at D7 showed that 80% and 100% of patients, accordingly, reported the overall summary satisfaction, 49% and 79% agreed with a complete pelvic pain relief by D7, 79% and 0% agreed with the absence of a significant discomfort during the first postoperative day, 71% and 100% reported no need for analgesics to relief pain in the assess area, 80% and 100% reported fast return to daily activity, and 19.7% and 100% still experienced pelvic pain at D7 (pain in the GVR group was more severe and required the use of analgesics) (all p < .05). At the same time, 94% and 96% patients were satisfied with the aesthetic result of the procedure at D7 ( p = n.s.). The comparison between GVЕ and GVR groups at M6 showed that 100% of patients in both groups reported overall satisfaction with treatment ( p = n.s.), 96% and 100% confirmed a complete pelvic pain relief by M6, 79% and 65% agreed with the absence of a significant discomfort after the procedure, 79% and 65% reported no need for analgesics, 83% and 100% reported about the return to daily activity (all p < .05), and 100% in both groups were satisfied with the aesthetic result of the procedure ( p = n.s.). Conclusions In patients with PeVD, both GVE and GVR are associated with a high, although not significantly different, overall treatment satisfaction in the long term and have advantages and disadvantages. GVE is associated with less severe post-procedural pain, while GVR provides faster relief of pelvic pain and a return to usual daily activity.

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Section: Methodsmentioning

confidence: 99%

Use of a novel Likert scale instrument to assess patient satisfaction following endovascular and surgical treatment of pelvic venous disorders

Grishenkova

Mishakina

et al. 2022

Phlebology

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“…Что касается эндоскопических вмешательств, то в зависимости от доступа выделяют ретроперитонеальную и трансперитонеальную резекции [42].…”

Section: лечениеunclassified

“…Данная методика оптимальна при одностороннем поражении гонадных вен. Кроме того, использование ретрокарбоксиперитонеума определяет возможность широкой мобилизации гонадной вены от яичника до левой почечной или нижней полой вен без травмирования органов брюшной полости [42].…”

Section: лечениеunclassified

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Chronic pelvic pain in women

2020

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Хроническая тазовая боль, возникающая в результате варикозной болезни вен малого таза,мультидисциплинарная проблема. Ключевая причина тазовой конгестии-врожденная или приобретенная несостоятельность клапанов гонадных вен. Ультразвуковое и допплерографическое исследование при хронической тазовой боли позволяет в большинстве наблюдений диагностировать тазовый варикоз. Мультиспиральная компьютерная или магнитно-резонансная томография детализирует характер и распространенность патологии. Золотым стандартом диагностики варикозной болезни вен малого таза считается селективная флебография. Консервативное лечение флеботропными препаратами назначается при ограниченном тазовом варикозе. Хирургические методы лечения включают открытые резекционные вмешательства, ретроперитонеальное и трансперитонеальное лапароскопическое иссечение гонадных вен или их клипирование. Наиболее эффективна мининвазивная эндоваскулярная окклюзия рефлюксных вен с использованием спиральных технологий и склерозантов. Чаще редуцируется левая яичниковая вена. Решение о билатеральной эмболизации сосудов зависит от выраженности изменения вен и интенсивности рефлюкса крови. Уменьшение интенсивности или исчезновение боли в области малого таза достигается в 80-100% наблюдений после процедуры. Диагностика этого состояния затруднена в связи с тем, что проявления тазового варикоза неспецифичны и включают симптомы хирургических, урологических, гинекологических и других заболеваний органов малого таза. Ключевые слова: варикозная болезнь вен малого таза, тазовая венозная конгестия, лучевая диагностика, эндоваскулярная окклюзия, хирургическое лечение. Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи. Источник финансирования. Авторы заявляют об отсутствии финансирования.

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Retrospective Analysis of Complications After Gonadal Vein Interventions for Pelvic Venous Disorder

Mishakina

Vasilyiev

et al. 2023

Journal of Surgical Research

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Endoscopic Technologies for the Diagnostics and Treatment of Pelvic Congestion Syndrome

Cited by 12 publications

References 12 publications

Use of a novel Likert scale instrument to assess patient satisfaction following endovascular and surgical treatment of pelvic venous disorders

Use of a novel Likert scale instrument to assess patient satisfaction following endovascular and surgical treatment of pelvic venous disorders

Chronic pelvic pain in women

Retrospective Analysis of Complications After Gonadal Vein Interventions for Pelvic Venous Disorder

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