New Technique Treats Pelvic Pain in Men and Women

Use of foam solution seems to prevent recurrence of disorder, researchers report

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By Steven Reinberg
HealthDay Reporter

FRIDAY, March 31, 2006 (HealthDay News) -- A minimally invasive surgical technique that includes the addition of a foam appears to successfully treat pelvic pain in both men and women, researchers report.

The conditions are, in men, enlarged varicose veins in the scrotum, known as varicoceles, and in women, enlarged varicose veins in the pelvis, called pelvic congestion syndrome. Varicoceles may cause pain, testicular atrophy or infertility, and pelvic congestion syndrome can cause disabling chronic pelvic pain.

The results of the new study were presented March 31 at the Society of Interventional Radiology annual meeting, in Toronto.

"This is a revised method of treating varicoceles and pelvic congestion syndrome," said study author Dr. Eric Reiner, an assistant professor of vascular and interventional radiology at Yale University School of Medicine.

In both conditions, the valves in the gonadal vein don't work, Reiner said. "Instead of blood going back to the heart like it normally does, it ends up staying in the vein causing the vein to get large and causing pain."

As many as 40 percent of women have chronic pelvic pain in their life, Reiner said. As for men, some 15 percent suffer from varicoceles, and the condition is involved in 50 percent of male infertility cases, he explained.

In their study, Reiner and his Yale researchers performed the procedure on 24 patients. As of the time of the presentation, there were no recurrences of the condition.

The goal of the treatment is to seal off the vein to prevent it from becoming engorged with blood, Reiner said. To do this, a needle is passed into the vein in the groin, then a tube is placed in the vein. Next, metal coils are passed through the tube into the vein. These act as a plug to block off the vein.

The new part of the procedure is the injection of a solution called sodium tetradecyl sulfate. The solution is then turned into foam using air or carbon dioxide. "This allows the solution to go into the smaller collateral veins, closing them off, too," Reiner said.

Other techniques, including this one without foam, often result in a recurrence of the condition, Reiner said. By closing off both the large vein and the smaller collateral veins, the researchers think that a recurrence of the condition is significantly less likely. "We are hoping that this will result in a longer, more permanent solution to the problem," Reiner said.

"The best part of the procedures is that they are day procedures," Reiner said. "You go in that day and go home that night. That's a huge benefit over surgical interventions for the same conditions that frequently have overnight stays and a longer recovery time."

While this technique is not yet being used widely, Reiner believes it will become more common in the future.

More information

The U.S. National Institutes of Health can tell you more about varicoceles.

SOURCES: Eric Reiner, M.D., assistant professor, vascular and interventional radiology, Yale University School of Medicine, New Haven, Conn.; March 31, 2006, presentation, Society of Interventional Radiology annual meeting, Toronto

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