[Embolization or sclerotherapy of pelvic veins in pelvic congestion syndrome]

Coelli J, Ciapponi A, Colaci C, Argento F, Alfie V, García Marti S, Bardach A, Augustovski F, Alcaraz A, Pichon Riviere A
Record ID 32018004418
Original Title: Embolización o escleroterapia de venas pelvianas en síndrome de congestión pelviana.
Authors' recommendations: No prospective studies have been found for the treatment of pelvic congestion syndrome that directly compares embolization or sclerotherapy of pelvic region veins versus laparoscopic pelvic vein ligation or medical treatment (analgesia and hormone replacement therapy) or hysterectomy-oophorectomy. Low-quality evidence shows that endovascular therapy (embolization and/or sclerotherapy), when compared with medical treatment, may result in a considerable benefit in terms of achieving chronic pain management. This has been assessed in retrospective studies, evaluating pain control before and after the procedure. Low-quality evidence suggests that endovascular therapy, when compared with surgical ligation for pelvic congestion syndrome, may result in a marginal benefit or even no statistical difference in terms of management of the pelvic pain. The clinical guidelines consulted consider endovascular therapy as a therapeutic option available for young patients or those with unmet parity. It highlights the low rate of complications and short surgical times. The rate of complications varies among studies, but it reaches a total of less than 10% of cases. In the retrospective studies assessed, the need for re-embolization ranges from 15 to 25% and varies with the technique used. Pain recurrence is estimated in approximately 13% after five years. Most Latin American, Unites States and European health funders do not cover this technology. Only one private funder from Unites States covers it when chronic pelvic pain does not respond to medical treatment and the diagnosis is confirmed by venogram or magnetic resonance imaging. In our country, endovascular therapies are covered with no specification as to the anatomical site. In Argentina, the cost-effectiveness of this technology for the indication assessed is unknown.
Project Status: Completed
Year Published: 2022
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Pelvic Pain
  • Sclerotherapy
  • Embolization, Therapeutic
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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