Endovenous embolization of pelvic congestion syndrome: Impact on pain, sexual function, and quality of life—A multidisciplinary prospective single-arm cohort study
Journal of Vascular Surgery: Venous and Lymphatic Disorders, cilt.14, sa.5, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 14 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.jvsv.2026.102532
- Dergi Adı: Journal of Vascular Surgery: Venous and Lymphatic Disorders
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Pelvic congestion syndrome, Endovenous embolization, Dyspareunia, Sexual function, Quality of life, Multidisciplinary treatment
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This prospective cohort study evaluated the impact of endovenous ovarian vein embolization (OVE) on pain, sexual function, psychiatric symptoms, and quality of life in patients with pelvic congestion syndrome (PCS). Methods: Eighty women with PCS aged 18 to 55 years presenting with chronic pelvic pain (visual analog scale [VAS] ≥4) lasting ≥6 months underwent OVE. Patients with confirmed pelvic venous reflux on venous reflux Doppler ultrasound examination using 3- to 5-MHz probes in supine and standing positions were classified using the 2021 Symptoms-Varices-Pathophysiology system. Outcomes were assessed at baseline, 3, and 6 months using a VAS, the Female Sexual Function Index (FSFI), the Arizona Sexual Experiences Scale (ASEX), the Hamilton Depression and Anxiety scales, and the Short Form-36 quality-of-life instrument. Statistical analysis included paired t-tests, Cohen's d effect sizes, and multivariate logistic regression. An a priori power analysis (G∗Power 3.1; Cohen's d = 0.8; power = 0.95) required a minimum of 68 participants. Patient recruitment occurred between February 2025 and August 2025, with 6-month follow-up assessments completed by February 2026. Results: The mean patient age was 36.7 ± 4.6 years with a parity of 3.6 ± 1.4. Most patients (67.5%) were S2-V2-PBGV,R,NT classification. At 6 months, significant improvements occurred: the VAS decreased 3.12 ± 2.51 points (Cohen's d = 1.68; P < .001), the FSFI score increased 7.28 ± 4.86 points (d = 1.21; P < .001), the ASEX score decreased 9.45 ± 6.34 points (d = 1.47; P < .001), the Hamilton Depression scale decreased 6.8 ± 3.6 points (P < .001), the Hamilton Anxiety scale decreased 8.1 ± 4.2 points (P < .001), and quality of life increased 28.42 ± 16.15 points (d = 2.24; P < .001). Response rates were 88.7% (VAS/quality of life), 86.2% (FSFI), and 87.5% (ASEX). Pelvic pain decreased in 93.7%, dyspareunia improved in 91.2%, and vaginismus resolved in 95.2%. Minor complications occurred in 6.25%. Dysmenorrhea (odds ratio [OR], 3.24), high parity (≥4 births; OR, 2.87), and prolonged symptom duration (≥2 years; OR, 2.15) were independent predictors of response. Conclusions: Endovenous OVE provides sustained, multidimensional improvement in patients with PCS, significantly enhancing sexual function, psychiatric health, and quality of life. Although the single-arm design limits causal attribution, the high response rates and favorable safety profile substantiate significant clinical benefit. The multidisciplinary management approach validates the importance of integrating vascular surgery and psychiatry.