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

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Abstract

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.

About the authors

Alexandr A. Kapto

Peoples’ Friendship University of Russia 

Author for correspondence.
Email: alexander_kapto@mail.ru

Candidate of Medical Science, Associate Professor, Department of Clinical Andrology, Faculty of Professional Development of Medical Workers of Medical Institute

Russian Federation, Moscow

References

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2. Fig. 1. Magnetic resonance imaging of the inferior vena cava and small pelvic vessels: (a) central proximal arteriovenous obstruction of the ileocaval segment; (b) central distal arteriovenous obstruction of the ileocaval segment; (c) left proximal arteriovenous obstruction of the ileocaval segment or May–Thurner syndrome; (d) left distal arteriovenous obstruction of the ileocaval segment; (e) right proximal arteriovenous obstruction of the ileocaval segment; and (f) right distal arteriovenous obstruction of the ileocaval segment (modeling)

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3. Fig. 2. Magnetic resonance examination of the inferior vena cava and small pelvic vessels. Left proximal and left distal types of arteriovenous conflicts of the ileoccava segment. The left arrow indicates the place of compression of the left common iliac vein with the right common iliac artery. The right arrow indicates the place of compression of the left external iliac vein by the left external iliac artery

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4. Fig. 3. Antegrade ileocavography of patient M., 39 years old, with pronounced pelvic symptoms (pain, erectile dysfunction, and chronic calculous prostatitis) due to May–Thurner syndrome: (а) antegrade catheterization of the left common iliac vein; (b) note retrograde reflux and contrast of the venous plexus of the small pelvis (collateral circulation) with the introduction of radiopaque substance; (c) after contrasting the venous plexus of the small pelvis, the radiopaque substance is redistributed into the right common iliac vein. The diameter of the right common iliac vein is 1.4 times smaller than the diameter of the left common iliac vein

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5. Fig. 4. Antegrade Ileokavagrafiya patient M., 39 years old, from 28.03.2017. Compression of the left common and left external iliac veins is noted. Operative access from the left popliteal vein. The position of the patient on the stomach

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6. Fig. 5. Balloon angioplasty of the left common and left external iliac veins of M. patient, 39 years old, from 28.03.2017. Operative access from the left popliteal vein. The position of the patient on the stomach

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7. Fig. 6. Implantation of one stent into the left general and left external iliac vein of the patient M., 39 years, from 28.03.2017. Operative access from the left popliteal vein. The position of the patient on the stomach

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8. Fig. 7. Postdilation of the stented segment of the left common iliac vein of M. patient, 39 years old, from 28.03.2017. Operative access from the left popliteal vein. The position of the patient on the stomach

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9. Fig. 8. Postdilation of the stented segment of the left external iliac vein of the patient M., aged 39, from 28.03.2017. Operative access from the left popliteal vein. The position of the patient on the stomach

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10. Fig. 9. Control phlebography of the patient M., 39 years old, from 28.03.2017. Operative access from the left popliteal vein. The position of the patient on the abdomen. Prolongability of both iliac veins and absence of collateral circulation

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11. Fig. 10. Results of IIEF-5 survey responses before and after angioplasty and stenting of the left common iliac and left external iliac veins (patient M., 39 years old)

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Copyright (c) 2018 Kapto A.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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