Trans-venous occlusion of incompetent pelvic veins for chronic pelvic pain in women

A systematic review

Vivak Hansrani, Abeera Abbas, Sahil Bhandari, Ann Louise Caress, Mourad Seif, Charles N. McCollum

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Chronic pelvic pain (CPP) affects 24% of women worldwide; the cause cannot be identified in 40% despite invasive investigations. Dilated, refluxing pelvic veins may be a cause of CPP and treatment by trans-venous occlusion is increasingly performed when gynecological causes are excluded, but is it effective? A systematic review of the literature published between 1966 and July 2014 was conducted. Two authors independently reviewed potential studies according to a set of eligibility criteria, with a third assessor available as an arbiter. Thirteen studies including 866 women undergoing trans-venous occlusion of pelvic veins for CPP were identified (Level of evidence: one study grade 2b, 12 studies grade four). Statistical significant improvements in pelvic pain were reported in nine of the 13 studies. Technical success was reported in 865 of 866 (99.8%) with low complication rates: coil migration in 14 women (1.6%), abdominal pain in ten women (1.2%) and vein perforation in five (0.6%). In a study on varicose veins of the legs, recurrence was seen in 13% of 179 women 5-years following coil embolization. Subjective improvements in pain were seen in all 13 studies after treatment by trans-venous occlusion. All 13 studies were of poor methodological quality. Complication rates were low and no fatalities occurred. Well-designed studies are essential to determine whether pelvic vein incompetence (PVI) is associated with CPP, and to explore whether trans-venous occlusion of PVI improves quality of life for these women.

Original languageEnglish
Pages (from-to)156-163
Number of pages8
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume185
DOIs
Publication statusPublished - 1 Feb 2015
Externally publishedYes

Fingerprint

Pelvic Pain
Chronic Pain
Veins
Varicose Veins
Abdominal Pain
Leg
Quality of Life
Recurrence
Pain
Therapeutics

Cite this

@article{3ec440b0d4dc46c48866aa11365bbf86,
title = "Trans-venous occlusion of incompetent pelvic veins for chronic pelvic pain in women: A systematic review",
abstract = "Chronic pelvic pain (CPP) affects 24{\%} of women worldwide; the cause cannot be identified in 40{\%} despite invasive investigations. Dilated, refluxing pelvic veins may be a cause of CPP and treatment by trans-venous occlusion is increasingly performed when gynecological causes are excluded, but is it effective? A systematic review of the literature published between 1966 and July 2014 was conducted. Two authors independently reviewed potential studies according to a set of eligibility criteria, with a third assessor available as an arbiter. Thirteen studies including 866 women undergoing trans-venous occlusion of pelvic veins for CPP were identified (Level of evidence: one study grade 2b, 12 studies grade four). Statistical significant improvements in pelvic pain were reported in nine of the 13 studies. Technical success was reported in 865 of 866 (99.8{\%}) with low complication rates: coil migration in 14 women (1.6{\%}), abdominal pain in ten women (1.2{\%}) and vein perforation in five (0.6{\%}). In a study on varicose veins of the legs, recurrence was seen in 13{\%} of 179 women 5-years following coil embolization. Subjective improvements in pain were seen in all 13 studies after treatment by trans-venous occlusion. All 13 studies were of poor methodological quality. Complication rates were low and no fatalities occurred. Well-designed studies are essential to determine whether pelvic vein incompetence (PVI) is associated with CPP, and to explore whether trans-venous occlusion of PVI improves quality of life for these women.",
keywords = "Chronic pelvic pain, Embolization, Pelvic congestion syndrome, Systematic review, Pelvic vein incompetence, Venous occlusion",
author = "Vivak Hansrani and Abeera Abbas and Sahil Bhandari and Caress, {Ann Louise} and Mourad Seif and McCollum, {Charles N.}",
year = "2015",
month = "2",
day = "1",
doi = "10.1016/j.ejogrb.2014.12.011",
language = "English",
volume = "185",
pages = "156--163",
journal = "European Journal of Obstetrics, Gynecology and Reproductive Biology",
issn = "0028-2243",
publisher = "Elsevier Ireland Ltd",

}

Trans-venous occlusion of incompetent pelvic veins for chronic pelvic pain in women : A systematic review. / Hansrani, Vivak; Abbas, Abeera; Bhandari, Sahil; Caress, Ann Louise; Seif, Mourad; McCollum, Charles N.

In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 185, 01.02.2015, p. 156-163.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Trans-venous occlusion of incompetent pelvic veins for chronic pelvic pain in women

T2 - A systematic review

AU - Hansrani, Vivak

AU - Abbas, Abeera

AU - Bhandari, Sahil

AU - Caress, Ann Louise

AU - Seif, Mourad

AU - McCollum, Charles N.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Chronic pelvic pain (CPP) affects 24% of women worldwide; the cause cannot be identified in 40% despite invasive investigations. Dilated, refluxing pelvic veins may be a cause of CPP and treatment by trans-venous occlusion is increasingly performed when gynecological causes are excluded, but is it effective? A systematic review of the literature published between 1966 and July 2014 was conducted. Two authors independently reviewed potential studies according to a set of eligibility criteria, with a third assessor available as an arbiter. Thirteen studies including 866 women undergoing trans-venous occlusion of pelvic veins for CPP were identified (Level of evidence: one study grade 2b, 12 studies grade four). Statistical significant improvements in pelvic pain were reported in nine of the 13 studies. Technical success was reported in 865 of 866 (99.8%) with low complication rates: coil migration in 14 women (1.6%), abdominal pain in ten women (1.2%) and vein perforation in five (0.6%). In a study on varicose veins of the legs, recurrence was seen in 13% of 179 women 5-years following coil embolization. Subjective improvements in pain were seen in all 13 studies after treatment by trans-venous occlusion. All 13 studies were of poor methodological quality. Complication rates were low and no fatalities occurred. Well-designed studies are essential to determine whether pelvic vein incompetence (PVI) is associated with CPP, and to explore whether trans-venous occlusion of PVI improves quality of life for these women.

AB - Chronic pelvic pain (CPP) affects 24% of women worldwide; the cause cannot be identified in 40% despite invasive investigations. Dilated, refluxing pelvic veins may be a cause of CPP and treatment by trans-venous occlusion is increasingly performed when gynecological causes are excluded, but is it effective? A systematic review of the literature published between 1966 and July 2014 was conducted. Two authors independently reviewed potential studies according to a set of eligibility criteria, with a third assessor available as an arbiter. Thirteen studies including 866 women undergoing trans-venous occlusion of pelvic veins for CPP were identified (Level of evidence: one study grade 2b, 12 studies grade four). Statistical significant improvements in pelvic pain were reported in nine of the 13 studies. Technical success was reported in 865 of 866 (99.8%) with low complication rates: coil migration in 14 women (1.6%), abdominal pain in ten women (1.2%) and vein perforation in five (0.6%). In a study on varicose veins of the legs, recurrence was seen in 13% of 179 women 5-years following coil embolization. Subjective improvements in pain were seen in all 13 studies after treatment by trans-venous occlusion. All 13 studies were of poor methodological quality. Complication rates were low and no fatalities occurred. Well-designed studies are essential to determine whether pelvic vein incompetence (PVI) is associated with CPP, and to explore whether trans-venous occlusion of PVI improves quality of life for these women.

KW - Chronic pelvic pain

KW - Embolization

KW - Pelvic congestion syndrome

KW - Systematic review, Pelvic vein incompetence

KW - Venous occlusion

UR - http://www.scopus.com/inward/record.url?scp=84921324816&partnerID=8YFLogxK

U2 - 10.1016/j.ejogrb.2014.12.011

DO - 10.1016/j.ejogrb.2014.12.011

M3 - Review article

VL - 185

SP - 156

EP - 163

JO - European Journal of Obstetrics, Gynecology and Reproductive Biology

JF - European Journal of Obstetrics, Gynecology and Reproductive Biology

SN - 0028-2243

ER -