A new approach to pelvic congestion in Cuba . Presentation of two cases

Abstract

In our country, gynecologists report a high incidence of suspicion of pelvic congestion. Nonetheless, the lack of knowledge about this pathology we have had in the medical level, and the lack of joined work between the two specialties, Gynecology and Angiology, have made this field unclear and have lead to the anachronous treatment in some cases, like psychiatric treatment or aggressive surgery (uterus exeresis). Clinical cases: We treated two women with suspicion of pelvic congestion. We made them abdominal and transvaginal US Doppler Color and selective pelvic phlebography. It was shown that, clinically, the selected cases had correlation with the US Doppler Color, verifying in both cases dilatation of vein lakes (over 5 mm ), the reason for which we proceeded we made a selective pelvic phlebography. One of the cases was diagnosed as moderated pelvic congestion without leak points. In the second case, positive to pelvic congestion, we developed a treatment from the endovascular point of view, putting coils and etoxisclerol foam (sandwich technique). For the first time in our country pelvic congestion is diagnosed and treated. Both women quickly recovered after the procedure without immediate complications. The patients were followed with embolization after 30 days and showed regression of the symptoms. After 50 days we made a control with a color ultrasound Doppler and observed a diminution of the vein lakes to 3 mm , considered normal.