scholarly journals May-Thurner syndrome and varicose veins of the pelvic organs in men

2018 ◽  
Vol 19 (4) ◽  
pp. 28-38
Author(s):  
A. A. Kapto
Keyword(s):  
Varicose Veins ◽  
Prostate Gland ◽  
Maximum Diameter ◽  
Study Objective ◽  
X Ray ◽  
Compression Syndrome ◽  
Pelvic Organs ◽  
Venous Compression ◽  
Left And Right ◽  
Angioplasty And Stenting

The study objectiveis to study the methods of diagnosis and treatment of iliac venous compression in men with urological and andrological pathology and varicose veins of the pelvic organs.Materials and methods. From 2015 to 2018, 110 patients with bilateral varicocele, varicose veins of the pelvic organs and May–Thurner syndrome in age from 17 to 69 years (mean 33.2 years) were examined. Ultrasound echography of the scrotum organs and vessels of the penis, including transrectal and Doppler mode, magnetic resonance phlebography, dynamic pharmacocavernosography were used for the examination.Results.The presence of bilateral varicocele in all patients was verified. Aorto-mesenteric compression in combination with iliac venous compression was detected in 36 (32.7 %) patients. X-ray surgical treatment of ileal venous compression syndrome was performed in 26 patients. After 3 months in all cases there was a decrease in the maximum diameter of the veins of the prostate gland. In 13 patients with isolated ileal compression (without combination with arterial aorto-mesenteric forceps), by 3 months after surgery, a reduction in varicocele was observed: in all cases the diameter of the left and right testicular veins lying and without tension was less than 2 mm.Conclusion.Angioplasty and stenting of the iliac veins in arterio-venous conflicts is a highly effective method of treating patients with varicose veins of the pelvic organs in combination with varicocele.

scholarly journals Diagnostic significance of phlebotonometry for evaluation of indications for angioplasty and stenting of compressed iliac veins in patients with varicocele and pelvic congestion disease

2020 ◽  
Vol 21 (1) ◽  
pp. 29-41
Author(s):  
A. A. Kapto
Keyword(s):  
Inferior Vena ◽  
Ultrasound Examination ◽  
Varicose Veins ◽  
Transrectal Ultrasound ◽  
Vena Cava ◽  
Resonance Imaging ◽  
Pelvic Organs ◽  
Left And Right ◽  
Angioplasty And Stenting ◽  
Valsalva Test

The aim of the study was to assess the information content of the phlebotonometry method when determining indications for endovascular x-ray angioplasty and stenting of the iliac veins during their arterial compression.Materials and methods. Thirty-six patients with bilateral varicocele and varicose veins of the pelvic organs were examined. The examination included assessment of the condition using the international index of erectile function, ultrasound examination of the scrotum organs with color Doppler mapping, transrectal ultrasound of the prostate and veins of the prostatic plexus, magnetic resonance imaging of the inferior vena cava and pelvic vessels, venography of the renal caval and ileocaval segments, phlebotonometry of these segments in a calm state and during the Valsalva test.Results. Pressure gradient between left and right external iliac veins >2 mm Hg in a calm state was detected in 4 (11.1 %) patients, >3 mm Hg with Valsalva test – in 9 (25.0 %) patients, between the left and right common iliac veins >2 mm Hg in a calm state – in 3 (8.3 %) patients, >3 mm Hg with a Valsalva test, in 15 (41.7 %) patients. At the same time, in 20 (55.6 %) of 36 cases, phlebotonometry data were of a contradictory logic nature, which we attribute to the insufficient sensitivity of this research method. Our data suggest that collateral circulation leads not only to varicose veins of the pelvic organs, but also to equalization of pressure in the ipsilateral segments of the iliac veins due to the law of communicating vessels.Conclusion. Phlebotonometry in the diagnosis of iliac venous compression can only be used as an additional research method. Indications for angioplasty and stenting of the iliac veins during compression should be determined on the basis of clinical data, the severity of varicose veins of the pelvic organs according to the results of transrectal ultrasound examination, the results of magnetic resonance imaging of the inferior vena cava and pelvic vessels (or computed tomography of the abdominal organs with contrast or multispiral computed tomography of the abdominal cavity organs), radiopaque phlebography and intravascular ultrasound.The author declares no conflict of interest.All patients gave written informed consent to participate in the study.

scholarly journals Endovascular surgery of the iliac veins with bilateral varicocele and varicose veins of the pelvic organs in men

2018 ◽  
Vol 8 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Alexandr A Kapto
Keyword(s):  
Surgical Treatment ◽  
Balloon Angioplasty ◽  
Varicose Veins ◽  
Endovascular Surgery ◽  
Promising Direction ◽  
Pelvic Organs ◽  
Venous Compression ◽  
Angioplasty And Stenting

In this study an analysis of the examination and treatment of 66 patients with bilateral varicocele, varicose veins of the pelvic organs due to ileal venous compression was performed. The obtained data testify to the need to review existing approaches to the surgical treatment of bilateral and recurrent varicocele. Carrying out balloon angioplasty and stenting in varicose veins of the pelvic veins in men due to the syndrome of ileal venous compression is currently an innovative and promising direction in urological practice at the interface of specialties. (For citation: Kapto AA. Endovascular surgery of the iliac veins with bilateral varicocele and varicose veins of the pelvic organs in men. Urologicheskie vedomosti. 2018;8(1):11-17. doi: 10.17816/uroved8111-17).

scholarly journals Reno-iliac intrasystem anastomoses of the inferior vena cava

2020 ◽  
Vol 21 (2) ◽  
pp. 51-57
Author(s):  
A. A. Kapto
Keyword(s):  
Inferior Vena Cava ◽  
Collateral Circulation ◽  
Inferior Vena ◽  
Varicose Veins ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Nutcracker Syndrome ◽  
Study Objective ◽  
Testicular Vein ◽  
X Ray

The study objective is to describe the anastomoses between the left renal and iliac veins in the inferior vena cava system and to classify these anastomoses.Materials and methods. From 2015 to 2020, 340 men with varicose veins of the pelvic organs and bilateral varicocele were examined. Delayed imaging for 10–30 s with phlebotesticulography of 157 patients allowed us to study in more detail the vascular venous x-ray anatomy of the scrotum and various options for collateral circulation.Results. The data obtained by us during phlebography allowed us to offer our own classification of anastomoses between the left renal vein and the common iliac vein in the inferior vena cava system (reno-iliac intrasystemic anastomoses of the inferior vena cava): 1) through the vein of the vas deferens (v. ductus deferens), 2) through the cremasteric vein (v. cremasterica), 3) through the external testicular vein (v. testicularis externa). In addition to the classification, the terms for specific types of anastomoses are also proposed by us for the first time and do not have a name in the medical scientific literature. A new definition of the term “venous anastomotic node (nodus venarum anastomoticus) of the testis and its appendage” is proposed, which describes the anatomical relationship between the 4 veins: the internal testicular vein, external testicular vein, vena cremasterica and veins of the vas deferens. A new term is proposed “pseudo-varicocele” that defines the compensatory expansion of the internal testicular vein during normal antegrade blood flow through it.Conclusion. In this work, we give an X-ray anatomical description of the development of various types of collateral circulation in the system of the inferior vena cava between the left renal vein and iliac vessels in various types of arteriovenous conflicts of both the upper (nutcracker syndrome, posterior nutcracker syndrome) and the lower level (May–Thurner syndrome).

scholarly journals Vascular conflicts in andrology. Part 2. Lower level arteryovenous conflicts

2019 ◽  
Vol 9 (3) ◽  
pp. 49-56
Author(s):  
Alexandr А. Kapto ◽  
Zoja V. Smyslova
Keyword(s):  
Erectile Dysfunction ◽  
Chronic Pelvic Pain ◽  
Varicose Veins ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Iliac Vein ◽  
Pelvic Pain Syndrome ◽  
Review Of The Literature ◽  
X Ray ◽  
Pelvic Organs

This paper presents a review of the literature on the prevalence, classification, symptoms, diagnosis and treatment of lower level arteriovenous conflicts. New approaches in the treatment of both arteriovenous conflicts and comorbid diseases such as varicocele, varicose veins of the pelvic organs, venogenic erectile dysfunction, chronic pelvic pain syndrome are presented. The data of the literature review can form the basis for the revision of approaches to the management of patients with varicocele, erectile dysfunction and chronic recurrent prostatitis. It is shown that x-ray surgical embolization of prostatic plexus veins alone or in combination with testicular vein embolization, angioplasty and iliac vein stenting is possible only at the junction of urology, andrology and x-ray surgery.

Pelvic congestion syndrome and left renal compression syndrome - clinical features and therapeutic approaches

VASA ◽  
2016 ◽  
Vol 45 (4) ◽  
pp. 275-282 ◽  
Author(s):  
Christina Jeanneret ◽  
Konstantin Beier ◽  
Alexander von Weymarn ◽  
Jürg Traber
Keyword(s):  
Varicose Veins ◽  
Left Renal Vein ◽  
Standing Position ◽  
Ovarian Vein ◽  
Pelvic Congestion Syndrome ◽  
Compression Syndrome ◽  
Abstract Knowledge ◽  
Increased Risk ◽  
Definition Of ◽  
Pelvic Congestion

Abstract. Knowledge of the anatomy of the pelvic, gonadal and renal veins is important to understand pelvic congestion syndrome (PCS) and left renal vein compression syndrome (LRCS), which is also known as the nutcracker syndrome. LRCS is related to PCS and to the presence of vulvar, vaginal and pudendal varicose veins. The diagnosis of the two syndromes is difficult, and usually achieved with CT- or phlebography. The gold standard is the intravenous pressure measurement using conventional phlebography. The definition of PCS is described as pelvic pain, aggravated in the standing position and lasting for more than 6 months. Pain in the left flank and microhaematuria is seen in patients with LRCS. Women with multiple pregnancies are at increased risk of developing varicose vein recurrences with pelvic drainage and ovarian vein reflux after crossectomy and stripping of the great saphenous vein. The therapeutic options are: conservative treatment (medroxyprogesteron) or interventional (coiling of the ovarian vein) or operative treatment (clipping of the ovarian vein). Controlled prospective trials are needed to find the best treatment.

Features hormonal hemostasis in patients with benign hyper-plastic processes of breasts

2016 ◽  
pp. 72-74 ◽  
Author(s):  
M. Makarenko ◽  
◽  
D. Govsieiev ◽  
O. Gromova ◽  
L. Martynova ◽  
...  
Keyword(s):  
Luteal Phase ◽  
Reproductive Organs ◽  
Breast Diseases ◽  
Hormonal Changes ◽  
Morphological Investigation ◽  
Fibrocystic Disease ◽  
X Ray ◽  
Pelvic Organs ◽  
Hormone Research ◽  
Gynecological Diseases

The objective: to study the incidence of gynecological diseases, clinical and hormonal parameters of the menstrual cycle in patients with benign hyper-plastic processes of breasts. Patients and methods. 65 women with various forms of mastitis were investigated. The following investigations were conducted: mammologistic and gynecological investigation, mommologistic X-ray investigation, ultrasound of breasts and of the pelvic organs, endometrial aspiration biopsy that was followed by cytology; when it was necessary the diagnostic laparoscopy, colposcopy, hysteroscope with curettage and morphological investigation of the endometrium, hormone research and rectal temperature measurements were conducted. Results. The frequency of the benign breast diseases was set: fibrocystic disease of breast – 32 women (49.2±6.20%), fibrous of breast – 16 women (24.6±5.34%), nodular of breasts – 8 women (12.3±4.07%), fibroadenoma – 6 women (9.2±3.59%), nodular disease of breasts on the background of fibroid changes – 3 women (4.6±2.60%). All in all, 96.9±2.14% of the patients had any gynecological diseases. Thus, the average age of the ‘debut’ of mastitis was 31.4±1.09 years; the hyper-plastic processes in the uterus was 35.2±1.17 years. Anovulation was detected in 17 (47.2±8.3%) patients, the lack of the luteal phase (NLF) was detected in 11 (30.6±7.6) patients. Conclusions. Identified hormonal changes are typical for patients with the hyper-plastic processes of the reproductive organs with different localization (breasts, uterus, ovaries). Due to the commonality of the hormone changes in most cases mastitis is combined with the various gynecological diseases (96.9±2.14%). Key words: gynecological pathology, hormonal changes, breast, factors of risk.

Linear Mandibular Measurements: Comparison between Orthopantomograms and Lateral Cephalograms

2009 ◽  
Vol 46 (2) ◽  
pp. 147-153 ◽  
Author(s):  
E. M. Ongkosuwito ◽  
M. M. J. Dieleman ◽  
A. M. Kuijpers-Jagtman ◽  
P. G. H. Mulder ◽  
J. W. van Neck
Keyword(s):  
Interobserver Variability ◽  
Intraclass Correlation ◽  
Kappa Statistics ◽  
Magnification Factor ◽  
Linear Measurements ◽  
Lateral Cephalogram ◽  
X Ray ◽  
Lateral Cephalograms ◽  
Left And Right ◽  
Cephalometric Measurements

Objective: To investigate the reliability of length measurements of the mandible by comparing orthopantomograms (OPTs) with lateral cephalograms. Design: Observational study. Setting: OPTs and lateral cephalograms were taken of 20 human dry skulls. Four orthodontists and four maxillofacial surgeons located landmarks on all radiographs using a computer program for cephalometric measurements. Intraobserver and interobserver variability in locating landmarks was assessed, as well as positioning of the skulls prior to radiography between the x-ray assistants. Magnification differences between the left and right side of the mandible on the OPT were determined for five skulls. Kappa statistics were used to calculate the intraclass correlation coefficient for intraobserver and interobserver differences. An F test was used to assess differences between methods and between type of observer. Results: No significant differences were found in the magnification factor of the left and right side of the mandible. Compared with a lateral cephalogram, the OPT had comparable reliability in measuring mandibular distances condylion-gonion, gonion-menton, and condylion-menton. No significant differences were observed between the x-ray assistants in taking the OPTs and lateral cephalograms or in repositioning the skulls. Significant differences were found between orthodontists and maxillofacial surgeons for landmark measurements. Conclusion: An OPT is as reliable as a lateral cephalogram for linear measurements of the mandible (condylion-gonion, gonion-menton, and condylion-menton).

scholarly journals Ventilation/perfusion mismatch during lung aeration at birth

2014 ◽  
Vol 117 (5) ◽  
pp. 535-543 ◽  
Author(s):  
Justin A. R. Lang ◽  
James T. Pearson ◽  
Arjan B. te Pas ◽  
Megan J. Wallace ◽  
Melissa L. Siew ◽  
...  
Keyword(s):  
Pulmonary Arteries ◽  
Left Lung ◽  
X Ray ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Iodine Level ◽  
Pulmonary Shunting ◽  
Left And Right ◽  
Near Term ◽  
The Right

At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase-contrast X-ray imaging and angiography we investigated the spatial relationships between lung aeration and the increase in PBF after birth. Six near-term (30-day gestation) rabbits were delivered by caesarean section, intubated and an intravenous catheter inserted, before they were positioned for X-ray imaging. During imaging, iodine was injected before ventilation onset, after ventilation of the right lung only, and after ventilation of both lungs. Unilateral ventilation increased iodine levels entering both left and right pulmonary arteries (PAs) and significantly increased heart rate, iodine ejection per beat, diameters of both left and right PAs, and number of visible vessels in both lungs. Within the 6th intercostal space, the mean gray level (relative measure of iodine level) increased from 68.3 ± 11.6 and 70.3 ± 7.5%·s to 136.3 ± 22.6 and 136.3 ± 23.7%·s in the left and right PAs, respectively. No differences were observed between vessels in the left and right lungs, despite the left lung not initially being ventilated. The increase in PBF at birth is not spatially related to lung aeration allowing a large ventilation/perfusion mismatch, or pulmonary shunting, to occur in the partially aerated lung at birth.

scholarly journals Pelvic Venous Congestion Secondary to a Circumaortic Renal Collar in an Adolescent Female: Report of a Case

2021 ◽  
Vol 09 (01) ◽  
pp. e56-e60
Author(s):  
Verónica Alonso-Arroyo ◽  
Jose Javier Velasco ◽  
Sonia Pérez-Bertólez ◽  
Maria Elena Molina ◽  
Jose Manuel Marugan-de-Miguelsanz ◽  
...  
Keyword(s):  
Renal Vein ◽  
Varicose Veins ◽  
Left Renal Vein ◽  
Recurrent Abdominal Pain ◽  
Massive Hemorrhage ◽  
Resonance Imaging ◽  
X Ray ◽  
Abdominal Palpation ◽  
Internal Iliac ◽  
Pelvic Congestion

AbstractWe report a 13-year-old girl who presented with a recurrent abdominal pain that started after her menarche. The abdominal palpation revealed tenderness over the left ovarian point. The laboratory study, ultrasonography, and abdominal X-ray were normal. The computed tomography and magnetic resonance imaging showed a double left renal vein with a retroaortic component, an increased left parauterine circulation, and ipsilateral ovarian vein engorgement. A diagnostic and therapeutic phlebography allowed a selective catheterization of a group of pelvic varicose veins draining to the left ovarian and to the internal iliac veins. There were no complications during the procedure and the symptoms disappeared 2 days later. Circumaortic left renal vein may cause hematuria, proteinuria, pelvic congestion syndrome, and massive hemorrhage during surgery. A conservative treatment is recommended for patients without gynecourological/renal symptoms or with mild hematuria. The endovascular treatment by gonadal venous embolization is safe and effective.

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