Format

Send to

Choose Destination
Phlebology. 2015 Dec;30(10):706-13. doi: 10.1177/0268355514554638. Epub 2014 Oct 16.

Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.

Author information

1
The Whiteley Clinic, Stirling House, Guildford, Surrey, UK Faculty of Health and Medical Sciences, University of Surrey, UK mark@thewhiteleyclinic.co.uk.
2
The Whiteley Clinic, Stirling House, Guildford, Surrey, UK Faculty of Health and Medical Sciences, University of Surrey, UK.
3
The Whiteley Clinic, Stirling House, Guildford, Surrey, UK.
4
The Imaging Clinic, Mount Alvernia Hospital, London, UK.

Abstract

OBJECTIVES:

To assess the suitability of transvaginal duplex ultrasonography to identify pathological reflux in the ovarian and internal iliac veins in women.

METHODS:

A retrospective study of patients treated in 2011 and 2012 was performed in a specialised vein clinic. Diagnostic transvaginal duplex ultrasonography in women presenting with symptoms or signs of pelvic vein reflux were compared with the outcomes of treatment from pelvic vein embolisation. A repeat transvaginal duplex ultrasonography was performed 6 weeks later by a blinded observer and any residual reflux was identified.

RESULTS:

Results from 100 sequential patients were analysed. Mean age 44.2 years (32-69) with mode average parity of 3 (0-5 deliveries). Pre-treatment, 289/400 veins were refluxing (ovarian - 29 right, 81 left; internal iliac - 93 right, 86 left). Coil embolisation was successful in 86/100 patients and failed partially in 14/100 - 5 due to failure to cannulate the target vein. One false-positive diagnosis was made.

CONCLUSION:

Currently there is no accepted gold standard for pelvic vein incompetence. Comparing transvaginal duplex ultrasonography with the outcome from selectively treating the veins identified as having pathological reflux with coil embolisation, there were no false-negative diagnoses and only one false-positive. This study suggests that transvaginal duplex ultrasonography could be the gold standard in assessing pelvic vein reflux.

KEYWORDS:

Duplex ultrasound; internal iliac veins; ovarian veins; pelvic vein reflux; varicose veins

PMID:
25324278
DOI:
10.1177/0268355514554638
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center