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Combination of High Ligation and Intraoperative Embolization using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
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A systematic review on isolated coil embolization for pelvic venous reflux
Sharon A Sutanto1, Matthew Tan1, Sarah Onida1
1Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, Charing Cross Hospital, London, United Kingdom.
Journal of Vascular Surgery. Venous and Lymphatic Disorders
|August 6, 2021
Summary
Percutaneous coil embolization (CE) effectively treats pelvic venous reflux (PVR), significantly improving chronic pelvic pain and related symptoms. While generally safe, further research is needed to confirm long-term outcomes of isolated CE for PVR.
Area of Science:
- Interventional Radiology
- Vascular Surgery
- Gynecology
Background:
- Pelvic venous reflux (PVR) causes chronic pelvic pain, dysmenorrhea, and dyspareunia, diminishing quality of life.
- Percutaneous coil embolization (CE) is a common treatment for PVR, but its isolated efficacy and safety require review.
Purpose of the Study:
- To systematically review the efficacy and safety of isolated percutaneous coil embolization (CE) for treating pelvic venous reflux (PVR).
Main Methods:
- A systematic search of MEDLINE and EMBASE databases (1990-2020) identified 20 studies with 970 adult patients undergoing isolated CE for PVR.
- Data extraction and review were conducted by two independent reviewers.
- Pooled analysis of visual analogue scale (VAS) scores evaluated pain changes before and after CE.
Main Results:
- Isolated CE demonstrated technical effectiveness, with a mean VAS score improvement of 5.47 points.
- Significant symptom improvements were observed: urinary urgency (78-100%) and dyspareunia (60-89.5%).
- Complications were rare; coil migration occurred in 19 patients. Pain recurrence rates ranged from 5.9-25% at 1-2 years.
Conclusions:
- Isolated CE is technically effective and offers clinical improvement for patients with PVR.
- Further trials are necessary to establish the long-term efficacy and safety of isolated CE for PVR.
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