Ovarian vein interventions in patients with combined radiologically significant left renal vein compression and symptomatic pelvic vein reflux.

In 30 seconds

This prospective cohort study assessed left renal vein compression (LRVC) and ovarian vein interventions in 63 women with LRVC identified among patients examined for pelvic venous disorders. None had renal symptoms or impaired left-kidney function on dynamic renal scintigraphy. Among 24 symptomatic patients treated with left ovarian vein resection or embolization, chronic pelvic pain and pelvic venous reflux were eliminated in all cases. Follow-up at 1 to 12 months found no deterioration in left renal vein outflow or left-kidney function. The findings support the feasibility of isolated ovarian vein intervention in selected symptomatic patients without hematuria.

Key findings

• LRVC was diagnosed in 23.6% of patients with pelvic venous disorders; 11.3% were symptomatic and 4.9% had hemodynamically significant compression on duplex ultrasound.
• None of the patients with LRVC had renal symptoms or impaired left-kidney filtration or secretory function on dynamic renal scintigraphy.
• In 24 symptomatic patients, ovarian vein intervention eliminated chronic pelvic pain and pelvic venous reflux in all cases.
• Follow-up showed no deterioration in left renal vein outflow or left-kidney function after intervention.

Why it matters

Renal vein compression can coexist with symptomatic pelvic venous reflux, raising concern that ovarian vein intervention might compromise renal drainage. In this cohort, selected patients had pelvic symptom improvement without observed renal functional or outflow deterioration during follow-up. These findings help inform assessment of the renal and pelvic venous systems together, while remaining limited to the population and follow-up studied.

What to keep in mind

The cohort was prospective but non-randomised, and follow-up after intervention was limited to 1 to 12 months.