Evaluation of embolization for periuterine varices involving chronic pelvic pain secondary to pelvic congestion syndrome

OBJECTIVES: To evaluate the clinical response and success rate after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome and to report the safety of endovascular treatment and its rate of complications. METHODS: Retrospective cohort of patients undergoing endovascular treatment of pelvic congestion syndrome in our department from January 2012 to November 2015. Data were analyzed based on patient background, imaging findings, embolized veins, rate of complications, and clinical response as indicated by the visual analog pain scale. RESULTS: We performed periuterine varices embolization in 22 patients during the study, four of which required a second embolization. Seventeen patients reported a reduction in pelvic pain after the first embolization and three patients reported a reduction in pelvic pain after the second embolization. Minor complications were observed in our patients, such as postural hypotension, postoperative pain, and venous perforation during the procedure, without clinical repercussion. CONCLUSION: Periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome appears to be an effective and safe technique

Evaluation of embolization of periuterine varices in patients with chronic pelvic pain secondary to congestion syndrome pelvic

Introdução: a dor pélvica crônica é um problema que afeta uma significativa parcela de pacientes que buscam atendimento ginecológico. Dentre suas etiologias, destaca-se a síndrome de congestão pélvica, causada por insuficiência venosa pélvica. A justificativa deste estudo foi verificar se a técnica endovascular pode ser considerada estratégia terapêutica efetiva e válida para a população brasileira. Objetivo: avaliar a resposta clínica e a taxa de sucesso após embolização de varizes periuterinas em pacientes com dor pélvica crônica secundária à síndrome de congestão pélvica, e relatar a segurança do tratamento endovascular e o índice de complicações. Materiais e métodos: coorte retrospectiva de pacientes submetidas a tratamento endovascular da síndrome de congestão pélvica em nosso serviço, no período de janeiro de 2012 até novembro de 2015. Foram analisados dados relativos aos antecedentes das pacientes, achados de exames de imagem, veias embolizadas, taxa de complicações e resposta clínica baseada na escala visual analógica de dor. Resultados: Foi realizada embolização de varizes periuterinas em 22 pacientes no período estudado, sendo que quatro delas realizaram uma segunda embolização. Foi observada redução da dor em 17 pacientes considerando-se a primeira embolização (77.3%) e em 3 pacientes na segunda embolização (75%). Foram observadas complicações menores em 5 pacientes, como hipotensão postural, dor no pós-operatório e perfuração venosa sem repercussão clínica durante o procedimento. Conclusão: O presente estudo apresentou resultados satisfatórios da embolização de varizes periuterinas na redução dos sintomas de pacientes com dor pélvica crônica secundária à síndrome de congestão pélvica, mostrando-se como método seguro.Introduction: Chronic pelvic pain accounts a significant number of gynecologic referrals. Among its etiologies, there is the pelvic congestion syndrome, caused by pelvic venous insufficiency. The rationale of this study was to determine whether endovascular technique can be considered effective and valid therapeutic strategy for the Brazilian population. Objective: To evaluate the clinical response and the success rate after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome, and report the safety of endovascular treatment and the rate of complications. Materials and methods: Retrospective cohort of patients undergoing endovascular treatment of pelvic congestion syndrome in our department from January 2012 to November 2015. Data were analyzed on the background of patients, imaging findings, embolized veins, rate complications and clinical response based on visual analog pain scale. Results: We performed peiruterine varices embolization in 22 patients during the study period, four of which held a second embolization. 17 patients reported a reduction in pelvic pain considering the first embolization (77.3%) and 3 patients in the second embolization (75%). Minor complications were observed in 5 patients, such as postural hypotension, postoperative pain and venous perforation during the procedure, without clinical repercussion. Conclusion: The present study showed satisfactory improvement of clinical symptons after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome, showing up as a safe method

Evaluation of embolization for periuterine varices involving chronic pelvic pain secondary to pelvic congestion syndrome

OBJECTIVES: To evaluate the clinical response and success rate after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome and to report the safety of endovascular treatment and its rate of complications. METHODS: Retrospective cohort of patients undergoing endovascular treatment of pelvic congestion syndrome in our department from January 2012 to November 2015. Data were analyzed based on patient background, imaging findings, embolized veins, rate of complications, and clinical response as indicated by the visual analog pain scale. RESULTS: We performed periuterine varices embolization in 22 patients during the study, four of which required a second embolization. Seventeen patients reported a reduction in pelvic pain after the first embolization and three patients reported a reduction in pelvic pain after the second embolization. Minor complications were observed in our patients, such as postural hypotension, postoperative pain, and venous perforation during the procedure, without clinical repercussion. CONCLUSION: Periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome appears to be an effective and safe technique

Comentários a uma sentença anunciada : o processo Lula

“Comentários a uma sentença: o Caso Lula” é talvez o mais importante documento jurídico publicado no Brasil em décadas. A presente coletânea de artigos nasceu de um movimento espontâneo e bastante significativo de juristas brasileiros e estrangeiros que examinaram cuidadosamente a sentença proferida no âmbito do processo que tramitou na 13ª Vara Federal de Curitiba, no caso que ficou conhecido na mídia como o do “tríplex do Guarujá”. <br>De la presentación de Geraldo Prad

Comentarios a una sentencia anunciada : el proceso Lula

El centenar de textos que conforman este libro -escritos por un movimiento de prestigiosos/as juristas y abogados- desgranan el procedimiento al que fue sometido Lula. En la opinión de las y los autores de los artículos las normas no fueron observadas, y su inobservancia llevó a que se dictaminase una decisión injusta. Frases del estilo "Voy a tomar una decisión revolucionaria, dejando de lado la ley, porque por la ley no se puede condenarlo de ninguna manera”, dichas en los juicios por las más altas autoridades judiciales militares y civiles, hoy son conocidas gracias a quienes se abocaron al trabajo de escuchar los audios de aquellas sesiones, nutriendo las reflexiones que argumentan sobre el imperativo de la hora: restablecer el estado de derecho y absolver al presidente Lula Da Silva