Case Report: A Novel Technique to Treat Right Gonadal Vein Reflux for Pelvic Venous Disease

approximately 1 year after surgery.Baseline demographic data was obtained including patient age, past medical history, preoperative diagnoses, clinical symptoms, and imaging.Postoperatively clinical symptoms and imaging were examined through chart review.Results: Four patients with symptomatic LRV compression: three female (3/4; 75%), one male (1/4; 25%) with average age of 31 years (range, 22-44 years).Past medical history of POTS (2/4; 50%), EDS (1/4; 25%), mast cell activation syndrome (1/4; 25%), MALS (3/4; 75%), popliteal entrapment syndrome (1/4; 25%), thoracic outlet syndrome (1/4; 25%) Eagle's syndrome (1/4; 25%), and superior mesenteric artery syndrome.Two of the patients had prior renal veins stenting that did not alleviate their pain.Time from LRV decompression to redevelopment of pain was on average 12 months (range, 8-18 months).Imaging showed recompression of the LRV in both cases due to a narrowed aortomesenteric angle (mean, 12 degrees) and the development of new collateral vessels in all patients.After auto transplantation, chronic abdominal pain again resolved, and patients reported improved quality of life.Conclusions: Posterior LRV compression can be treated by decompressing the vein, however, reintervention is common and may be required due to recurrent compression of the LRV due to a narrowed aortomesenteric angle.In patients with symptomatic posterior LRV compression, auto transplantation should considered the first-line surgical choice.