Does lauromacrogol 3% alone is effective in management of pelvic congestion syndrome through transcatheter ovarian vein embolization?

Background: Pelvic congestion syndrome (PCS) refers to non-cyclical, persistent pelvic pain that lasts longer than six months and is primarily felt by women during the childbearing years. Trans-catheter ovarian vein embolization is now thought to be the 1 ^st line of therapy for pelvic congestion syndrome. The goal of this research was to evaluate the role of trans-catheter gonadal vein embolization in treatment of pelvic venous disorder in females having Symptomatic PCS. We chose the sclerosant foam (Lauromacrogol 3%) as an embolic material to assess its efficacy in management of PCS as the cost of other embolic materials including embolization plugs, coils and glue is very high to our populations in Egypt. Methods: This prospective cohort research has been performed on fifty female cases (with mean age 30.7 years) with CPP persistent for over six months poorly responsive to medical treatment. All cases have been referred to the IR unit for gonadal veins embolization. We chose Sclerosant foam (Lauromacrogol 3%) as an embolic material then the patients underwent 6-month monitoring duration to evaluate the outcomes and recurrence rates using VAS and transvaginal ultrasound. Results: VAS declined dramatically from 8.8±1.2 (mean +/- SD) pre-procedure to 1.8±1.4 (mean +/- SD) post-procedure (highly significant P value <0.001). The technical success rate of pelvic vein embolization was 100%; the clinical success has been determined by the TVUS, which demonstrated either complete resolution of the pelvic varices or static varices, and the VAS, which demonstrated a marked improvement. Conclusions: The management of pelvic congestion syndrome through gonadal vein embolization using Sclerosant foam (Lauromacrogol 3%) is an effective and safe procedure with 100% technical success rate and dramatic improvement of pelvic pain and varices. Moreover it is a cost effective procedure.