Ovarian vein transposition to the iliac vein can significantly improve quality of life for women with chronic pelvic pain due to Nutcracker Syndrome


John White (Chicago, USA) talks to Venous News at this year’s European Society for Vascular Surgery annual meeting (ESVS 2022; 20–23 September, Rome, Italy), about a procedure that is designed to help treat women who suffer from chronic pelvic pain brought about by Nutcracker Syndrome. White outlines how Nutcracker Syndrome leads to pelvic pain, and describes how ovarian vein transposition to the iliac vein can help alleviate this.

“The concept of the procedure is to accept that the ovarian vein provides excellent venous outflow for the left kidney”, says White. “We need to divert that into a larger vein however, so we transpose the ovarian vein to the iliac vein which can accommodate a large amount of blood flow. This has the tendency to eliminate flow into the pelvic varicose veins, thereby relieving pelvic pain,” he adds.

According to White, as many as 20 million women worldwide suffer chronic pelvic pain of an unknown cause, with many of these cases due to Nutcracker Syndrome. “Quality of life is an essential outcome marker for any procedure and what we have found is that ovarian vein transposition to the iliac vein significantly improves quality of life of those with pelvic pain”, he explains.

Women who suffer chronic pelvic pain of no known cause, should consider seeing their vascular specialist to see if they might have Nutcracker Syndrome, says White, before concluding that “our key message to vascular specialists is that there is a relatively simple and effective operation that can reduce the pelvic pain associated with Nutcracker Syndrome”.


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