Suprapubic percutaneous sclero-embolization of symptomatic female pelvic varicocele under local anesthesia

A. Tinelli, R. Prudenzano, M. Torsello, A. Malvasi, G. De Nunzio, I. De Mitri, M. Bochicchio, D. A. Tsin, P. Krishnan, Jose M. Wiley

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Purpose: To evaluate the safety and feasibility of supra-pubic percutaneous sclero-embolization (SE) in the treatment of symptomatic female pelvic varicocele (FPV), performed under local anesthesia. Materials and Methods: The authors selected 28 patients screened by transabdominal and transvaginal ultrasound, with venous Doppler signal. Clinicians performed SE by transfemoral catheterization, under local anesthesia, using of a mix of 2 ml of lauromacrogol 400 (Atossisclerol 3%, Chemische F. Kreussler, Wiesbaden, Germany) and 2 ml of air, in a mixed foam fashion. Results: The total operative time for SE was 7.6±2.1 min. Intra-surgical blood loss was 40±14 ml. No migration of sclerosant material occurred and postoperative analgesic request during a 48 hr period occurred in 6 patients. Technical success was 100%. The Authors embolized 8 women bilaterally (28.5%),18on the left ovarian vein (OV) (64.2%) and 2 only in the right OV (7.1%): 7 women complained of transitory flank pain (25%), which disappeared in few minutes. The major complications in 10 days after SE were: fever (>38°C for two days) in 2 patients (7.1%) and pelvic pain for 3 days in eight patients (28.5%). After 30 days only 6 women suffered of FPV lower symptoms which disappeared in 180 days. Asubstantial reduction in size of pelvic varicosities was noted inall patients. Conclusions: SE is a safe and feasible procedure. It reduces significantly the mean time of scopies, the intensity of radiation emission, and it is performed under local anaesthesia. This minimally invasive procedure could be proposed to all women with supra-pubic FPV for its reproducibility and feasibility.

Original languageEnglish (US)
Pages (from-to)111-117
Number of pages7
JournalEuropean Review for Medical and Pharmacological Sciences
Volume16
Issue number1
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

Varicocele
Local Anesthesia
Veins
Surgical Blood Loss
Sclerosing Solutions
Flank Pain
Pelvic Pain
Operative Time
Catheterization
Germany
Analgesics
Fever
Air
Radiation
Safety

Keywords

  • Chronic pelvic pain
  • Female pelvic varicocele
  • Minimally invasive treatmen
  • Ovarian vein valve incompetence
  • Pelvic congestion syndrome
  • Sclero-embolization
  • Venous vascular congestion

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

Cite this

Suprapubic percutaneous sclero-embolization of symptomatic female pelvic varicocele under local anesthesia. / Tinelli, A.; Prudenzano, R.; Torsello, M.; Malvasi, A.; De Nunzio, G.; De Mitri, I.; Bochicchio, M.; Tsin, D. A.; Krishnan, P.; Wiley, Jose M.

In: European Review for Medical and Pharmacological Sciences, Vol. 16, No. 1, 01.2012, p. 111-117.

Research output: Contribution to journalReview article

Tinelli, A, Prudenzano, R, Torsello, M, Malvasi, A, De Nunzio, G, De Mitri, I, Bochicchio, M, Tsin, DA, Krishnan, P & Wiley, JM 2012, 'Suprapubic percutaneous sclero-embolization of symptomatic female pelvic varicocele under local anesthesia', European Review for Medical and Pharmacological Sciences, vol. 16, no. 1, pp. 111-117.
Tinelli, A. ; Prudenzano, R. ; Torsello, M. ; Malvasi, A. ; De Nunzio, G. ; De Mitri, I. ; Bochicchio, M. ; Tsin, D. A. ; Krishnan, P. ; Wiley, Jose M. / Suprapubic percutaneous sclero-embolization of symptomatic female pelvic varicocele under local anesthesia. In: European Review for Medical and Pharmacological Sciences. 2012 ; Vol. 16, No. 1. pp. 111-117.
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abstract = "Purpose: To evaluate the safety and feasibility of supra-pubic percutaneous sclero-embolization (SE) in the treatment of symptomatic female pelvic varicocele (FPV), performed under local anesthesia. Materials and Methods: The authors selected 28 patients screened by transabdominal and transvaginal ultrasound, with venous Doppler signal. Clinicians performed SE by transfemoral catheterization, under local anesthesia, using of a mix of 2 ml of lauromacrogol 400 (Atossisclerol 3{\%}, Chemische F. Kreussler, Wiesbaden, Germany) and 2 ml of air, in a mixed foam fashion. Results: The total operative time for SE was 7.6±2.1 min. Intra-surgical blood loss was 40±14 ml. No migration of sclerosant material occurred and postoperative analgesic request during a 48 hr period occurred in 6 patients. Technical success was 100{\%}. The Authors embolized 8 women bilaterally (28.5{\%}),18on the left ovarian vein (OV) (64.2{\%}) and 2 only in the right OV (7.1{\%}): 7 women complained of transitory flank pain (25{\%}), which disappeared in few minutes. The major complications in 10 days after SE were: fever (>38°C for two days) in 2 patients (7.1{\%}) and pelvic pain for 3 days in eight patients (28.5{\%}). After 30 days only 6 women suffered of FPV lower symptoms which disappeared in 180 days. Asubstantial reduction in size of pelvic varicosities was noted inall patients. Conclusions: SE is a safe and feasible procedure. It reduces significantly the mean time of scopies, the intensity of radiation emission, and it is performed under local anaesthesia. This minimally invasive procedure could be proposed to all women with supra-pubic FPV for its reproducibility and feasibility.",
keywords = "Chronic pelvic pain, Female pelvic varicocele, Minimally invasive treatmen, Ovarian vein valve incompetence, Pelvic congestion syndrome, Sclero-embolization, Venous vascular congestion",
author = "A. Tinelli and R. Prudenzano and M. Torsello and A. Malvasi and {De Nunzio}, G. and {De Mitri}, I. and M. Bochicchio and Tsin, {D. A.} and P. Krishnan and Wiley, {Jose M.}",
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T1 - Suprapubic percutaneous sclero-embolization of symptomatic female pelvic varicocele under local anesthesia

AU - Tinelli, A.

AU - Prudenzano, R.

AU - Torsello, M.

AU - Malvasi, A.

AU - De Nunzio, G.

AU - De Mitri, I.

AU - Bochicchio, M.

AU - Tsin, D. A.

AU - Krishnan, P.

AU - Wiley, Jose M.

PY - 2012/1

Y1 - 2012/1

N2 - Purpose: To evaluate the safety and feasibility of supra-pubic percutaneous sclero-embolization (SE) in the treatment of symptomatic female pelvic varicocele (FPV), performed under local anesthesia. Materials and Methods: The authors selected 28 patients screened by transabdominal and transvaginal ultrasound, with venous Doppler signal. Clinicians performed SE by transfemoral catheterization, under local anesthesia, using of a mix of 2 ml of lauromacrogol 400 (Atossisclerol 3%, Chemische F. Kreussler, Wiesbaden, Germany) and 2 ml of air, in a mixed foam fashion. Results: The total operative time for SE was 7.6±2.1 min. Intra-surgical blood loss was 40±14 ml. No migration of sclerosant material occurred and postoperative analgesic request during a 48 hr period occurred in 6 patients. Technical success was 100%. The Authors embolized 8 women bilaterally (28.5%),18on the left ovarian vein (OV) (64.2%) and 2 only in the right OV (7.1%): 7 women complained of transitory flank pain (25%), which disappeared in few minutes. The major complications in 10 days after SE were: fever (>38°C for two days) in 2 patients (7.1%) and pelvic pain for 3 days in eight patients (28.5%). After 30 days only 6 women suffered of FPV lower symptoms which disappeared in 180 days. Asubstantial reduction in size of pelvic varicosities was noted inall patients. Conclusions: SE is a safe and feasible procedure. It reduces significantly the mean time of scopies, the intensity of radiation emission, and it is performed under local anaesthesia. This minimally invasive procedure could be proposed to all women with supra-pubic FPV for its reproducibility and feasibility.

AB - Purpose: To evaluate the safety and feasibility of supra-pubic percutaneous sclero-embolization (SE) in the treatment of symptomatic female pelvic varicocele (FPV), performed under local anesthesia. Materials and Methods: The authors selected 28 patients screened by transabdominal and transvaginal ultrasound, with venous Doppler signal. Clinicians performed SE by transfemoral catheterization, under local anesthesia, using of a mix of 2 ml of lauromacrogol 400 (Atossisclerol 3%, Chemische F. Kreussler, Wiesbaden, Germany) and 2 ml of air, in a mixed foam fashion. Results: The total operative time for SE was 7.6±2.1 min. Intra-surgical blood loss was 40±14 ml. No migration of sclerosant material occurred and postoperative analgesic request during a 48 hr period occurred in 6 patients. Technical success was 100%. The Authors embolized 8 women bilaterally (28.5%),18on the left ovarian vein (OV) (64.2%) and 2 only in the right OV (7.1%): 7 women complained of transitory flank pain (25%), which disappeared in few minutes. The major complications in 10 days after SE were: fever (>38°C for two days) in 2 patients (7.1%) and pelvic pain for 3 days in eight patients (28.5%). After 30 days only 6 women suffered of FPV lower symptoms which disappeared in 180 days. Asubstantial reduction in size of pelvic varicosities was noted inall patients. Conclusions: SE is a safe and feasible procedure. It reduces significantly the mean time of scopies, the intensity of radiation emission, and it is performed under local anaesthesia. This minimally invasive procedure could be proposed to all women with supra-pubic FPV for its reproducibility and feasibility.

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KW - Female pelvic varicocele

KW - Minimally invasive treatmen

KW - Ovarian vein valve incompetence

KW - Pelvic congestion syndrome

KW - Sclero-embolization

KW - Venous vascular congestion

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JO - European Review for Medical and Pharmacological Sciences

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