الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Embolization of gonadal veins is considered to be both effective and safe procedure with high clinical success rate and degree seems to reduce pain score in VAS. A large prevalence study of concurrent pelvic and lower limb varices should be prospectively randomized through prolonged follow up period for those females who suffer from pelvic venous insufficiency.
RECOMMENDATIONS
Based on the results of the study we strongly recommend a multidisciplinary team of vascular surgeons, radiologists, gynaecologists and psychiatrists for those female patients with larger clinical trial study with other centers for more data flowing.
LIMITATIONS OF THE STUDY
1. Relatively small number of cases
2. Single center enrollment
3. Lack disease specific accurate measures
4. Needs longer follow up periods for flowing more data
SUMMARY
The study was designed to evaluate pelvic pain reduction during a-12 month follow up period after different gonadal veins embolization modalities in women suffering of pelvic congestion syndrome (PCS). We present our first prospective data collection for embolization of incompetent refluxing gonadal veins in women suffering from pelvic pain at Ain Shams University Hospitals with standard methods of venous reporting. In addition we also evaluate the effectiveness of some embolic agents in treating pelvic venous insufficiency (PVI) through close follow up (12 months) using Visual Analogue Scale (VAS).
Data were collected from 11/2019 and 4/2021 from twenty four female patients with (type I PCS) chronic pelvic pain that were recruited prospectively at Ain Shams university Hospital, these patients were referred to our department of vascular surgery from department of gynecology with mean age 34.25±4.33 years, where they were candidates for gonadal veins embolization. Inclusion criteria: females in child bearing period who suffer from chronic pelvic pain for more than 6 month with>6mm gonadal veins diameter by ultrasound with presence of venous reflux. Exclusion criteria: pregnancy, local gynecological diseases like endometriosis and fibroid, type II PCS (reflux secondary to obstructive pathology or external compression) post phelpitic iliac veins or acute or chronic iliac veins thrombosis. Both gonadal veins were targeted for embolization and pain level was assessed by VAS before and after treating these veins over 12 months. Clinical, technical success and complications were observed. New tools for symptoms, varices and pathophysiology (SVP) as well as lower limb clinical, etiology, anatomy and pathophysiology (CEAP) tools were our venous standard reporting system that turned our sample into homogenous cohort group.
Clinical success were 100% with significant improvement of symptoms and reduction in VAS (p value < 0.001) over the period of the study.
Gonadal veins embolization is effective, feasible and safe method for treating PCS & improve symptoms with clinical success rate and high degree of patients’ satisfaction.