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Yale-New Haven Hospital news release
Release date: March 31, 2006
Media contact: Mark D'Antonio, (203) 688-2493

Yale-New Haven Hospital study finds new outpatient procedure may be successful alternative to surgery for female chronic pelvic pain and male infertility

Clinical researchers at Yale-New Haven Hospital (YNHH) have announced the results of a small trial that found that an improved, non-surgical outpatient interventional radiology image-guided treatment may be a successful alternative to surgery for two common, but not well recognized causes of debilitating pelvic pain in women and testicular pain in men. The results of the study were presented at the 31st Annual Scientific Meeting of the Society of Interventional Radiology in Toronto, Ontario, Canada.

"For years, we have used image-guided outpatient treatment for varicocele, a common cause of pain and infertility in men,” said Robert I. White, Jr., MD, professor of diagnostic radiology at Yale University’s School of Medicine and director of the Yale-New Haven Hospital’s vascular malformation center. “Pelvic congestion syndrome is much more elusive. Many women with these symptoms go years before a diagnosis is made. This new, enhanced image-guided procedure has shown to be effective in treating both pelvic pain and testicular pain."

Transcatheter gonadal embolotherapy – the new interventional radiological procedure – uses a combination of fibered coils and a liquid sclerosant foam. Fibered coils, in use for the past 25 years, have been fairly successful in treating varicocele in men and slightly less successful in treating women. The sotradecol foam, which was FDA-approved for use on varicose veins in 2004, is a special chemical used to damage the inside of veins and ultimately close them.

Doctors at YNHH have so far treated 16 patients suffering from varicocele (six adults and 10 adolescents, aged 12-19) and eight female patents (ages 26-41 years). Fifteen of the 16 varicole patients no longer have pain, and all of the women have shown improvement – more than half showing marked improvement.

In women, a condition called pelvic congestive syndrome (PCS) causes chronic pelvic pain that occurs mostly in the upright position, is progressive during the day, and is generally relieved by lying down. The condition – sometimes called varicose veins of the pelvis – is often associated with varicose veins of the legs, and is due to an absence of valves in one or both ovarian veins. Since women with this condition often have a normal MRI of the pelvis, gynecologists have difficulty diagnosing the large veins on examination.

In males, the condition, called varicocele, is a common cause of testicular and scrotal pain in men and testicular atrophy in adolescent boys. About 10 percent of males and nearly 40 percent of males with infertility suffer from varicocele, where a varicose vein of the left scrotum may cause pain, testicular atrophy and infertility. As with PCS, this condition is also due to the absence of valves in a vein, in this case, the internal spermatic vein.

"With addition of sotradecol foam, we are hopeful we can improve on the cure of varicocele and reduce the number of recurrences of pelvic congestion syndrome,” concluded Dr. White. “If others find similar results as they begin to duplicate this new approach, this will represent a major advancement in the interventional radiologic treatment of varicocele and pelvic congestion."

Dr. Eric Weiner, assistant professor of diagnostic radiology, will be presenting the paper on Friday afternoon, March 31, and he and Dr. White will hold a joint press conference to announce their work in the morning. Drs. Jeffrey S. Pollack and Michael Tal are also co-authors.

Reporters: For more information on this release, contact Mark D'Antonio, (203) 688-2493.

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Last revised: March 31, 2006 (mv)

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