In Reply to: Re: Case 1199_07 -- Severe Ovarian Vein Syndrome posted by Moni Stein on November 04, 1999 at 18:40:29:
I think that the venogram should be done. This is a dynamic issue - does the patient have inadequate valve function with reversal of flow in the ovarian veins? The only way to study this is by injection of the L Renal Vein with the patient semi-erect. No non-invasive imaging modality will show you the direction of flow with the patient erect/semi-erect.
The diagnostic venogram is quick (15-25 min, requires minimal contrast, adn is safe. If it's normal (3-4mm Ovarian Vein with functioning valves), you have excluded OVS and th epatient goes home. If it's abnormal you go on to the embolization directly. It's certainly less of a burden and risk than a diagnostic/exploratory laparoscopy.