Abstract No. 605 Resolution of Urinary Symptoms Following Pelvic Venous Disorder Treatment: A Small Case Series

To assess the efficacy of treatment of urinary symptoms in patients with pelvic venous disorders. The authors performed a retrospective case review of patients with urinary symptoms and concomitant findings of pelvic venous disorders treated with either iliac vein stenting or ovarian vein embolization from 2019 to 2023. During the period in question, 206 pelvic venograms were performed, approximately 60 specifically for pelvic venous disorders. Patients included in this analysis were those who had a diagnosis of interstitial cystitis (IC) or dominant urinary symptoms such as recurrent urinary tract infections, dysuria, and pelvic pain without the diagnosis of IC. The diagnosis of concomitant pelvic venous congestion and/or reflux was confirmed by venography in the preoperative or intraoperative period. Outcomes were determined by patient self-reported symptoms in clinic follow up 1-6 months following intervention. 7 female patients (5 with IC) with an average age of 43.3 years met criteria for inclusion. 3 patients demonstrated venography findings of iliac compression and received left common iliac venous stents. 4 patients demonstrated venographic findings of left ovarian reflux and received left ovarian vein embolization. Following treatment, all 5 of the patients with IC had resolution of IC related symptoms within 5 months (average of 1.9 months). Both of the remaining patients with urinary dominant symptoms without a diagnosis of IC had complete resolution of symptoms at 1 month follow-up. One IC patient received hydrodistension following treatment, but her symptoms have not recurred despite being outside of the 6-9 month therapeutic window for this treatment. In this small case series, the treatment of pelvic venous disorders led to the resolution of IC related symptoms and urinary symptoms in the treated patients. Prospective randomized controlled trials and larger retrospective analyses are indicated to evaluate the relationship between urinary symptoms (including IC) and pelvic venous congestion syndrome further.