Abnormal uterine bleeding after ovarian vein embolotherapy for pelvic congestion syndrome: Case report and review of literature

Pelvic congestion syndrome was firstly described by Taylor in 1949. It results from vascular engorgement of the uterus and the vessels of the broad ligament and lateral pelvic wall, which may lead to chronic pelvic pain[1]. Percutaneous transcatheter embolotherapy, firstly introduced by Edwards et al.[2] in 1993, is claimed to be a safe and effective treatment for the syndrome. In published studies, rates of significant relief varied from 50% to 100%[3-7]. The largest published series to date[4] describes 127 patients, 106 of whom underwent bilateral ovarian vein sclerotherapy followed by coil embolization. Eighty-three percent of the patients demonstrated relief of symptoms, 13% were no better, and 4% were worse. Generally, the procedure has few associated complications. One study involving 56 cases indicated no significant change in menstrual cycle[7]. Recently, procedure has been described to be successful in a pediatric patient with chronic pelvic pain[8].