Comparison of ovarian vein embolization alone with pelvic venous plexus embolization in the treatment of pelvic venous disorders at 12-month follow-up

OBJECTIVE: Percutaneous endovenous embolization has emerged as a treatment of choice for nonobstructive pelvic venous disorders (PeVD) due to its effectiveness, ease of application, and less invasiveness compared with surgical interventions. In this study, we aimed to analyze 12-month outcomes of the pelvic venous plexus embolization (PVPE) approach and the ovarian vein embolization alone (OVEA) approach. METHODS: This retrospective cohort included 72 women with PeVD who underwent percutaneous endovenous embolization between 2022 and 2024. Patients were assigned to OVEA or PVPE. Symptoms such as chronic pelvic pain, dyspareunia, postcoital pain, and dysmenorrhea were assessed using the visual analog scale at baseline and 12 months. Bladder symptoms were recorded as present/absent. Recurrence was defined as reappearance or worsening of symptoms within 12 months postprocedure. The primary outcome was 12-month symptom relief; secondary outcomes were recurrence and complications. RESULTS: Technical success rate was 100%. Visual analog scale scores for chronic pelvic pain, dyspareunia, and postcoital pain at the 12th month were significantly lower in the PVPE group compared with OVEA (P = .001, P = .008, and P = .005, respectively). Recurrence was statistically significantly lower in two patients in the PVPE group compared with nine patients in the OVEA group (P = .036). The mean diagnosis time was found to be 34.98 ± 9.03 months. CONCLUSIONS: PeVD is a heterogeneous clinical condition in which both venous reflux and venous outflow obstruction may contribute to symptom development. Our study demonstrated that, in patients with nonobstructive PeVD, the PVPE approach may provide better symptomatic relief and reduced recurrence rates. Long-term results of this approach should be supported by further studies to reach a more solid scientific basis for the management of PeVD.