Anatomy of ovarian and testicular vein reflux:
The left ovarian vein in women and the left testicular vein in men drain into the left renal vein. Like the leg veins, these veins have one-way check valves to prevent reflux. If these check valves fail, reflux develops down these veins into the ovarian area in women and the scrotal area in men. Most patients with this type of reflux have no other underlying vein problem.
However, if you have left renal vein compression, reflux in the renal vein puts pressure on the ovarian and testicular vein one-way check valves. If these valves fail, reflux flows into veins in the pelvic area. In some patients the ovarian and testicular vein reflux serves as a pressure relief mechanism for the left renal vein. Care should be taken to differentiate the origin of the ovarian/testicular vein reflux prior to making treatment recommendations.
Symptoms: Ovarian vein reflux in women with pelvic vein disease may include painful periods (dysmenorrhea), pain with urination (dysuria) and pain or fullness during or after intercourse (dyspareunia). Other less common symptoms include GI symptoms. Symptoms of testicular vein reflux in men include testicular pain and infertility issues. In both men and women, this reflux can feed varicose veins in the thigh and legs. In this case, symptoms of chronic vein disease may be present: heaviness, aching, swelling, throbbing, burning pain, skin changes and restless leg.
Physical findings: In women with ovarian vein reflux, physical findings include varicose veins in the labia and vagina, hemorrhoids, varicose veins in the upper thigh, buttocks, thigh, and leg. In men with testicular vein reflux, a cluster of varicose veins are easily palpated in the scrotum. When the reflux is feeding varicose veins in the thigh and legs, visible signs of chronic vein disease may be present: spider veins, varicose veins, leg swelling, skin changes, healed venous ulcers and active ulcers.
Endovascular Treatment: Innovative endovascular techniques are completed in our out-patient vascular treatment center. If you have isolated reflux in the left ovarian or testicular veins, use of coils and sclerosants may effectively eliminate the reflux improving the symptoms. If left renal vein compression is present, treating the left renal vein may eliminate the back pressure allowing the ovarian vein reflux and symptoms to improve.
Surgical Treatment: Even in an era of minimally invasive procedures, there are circumstances where traditional surgery may remain the best choice. Rest assured that we will offer you ‘better’ vein care with the least interference in your daily routine. If are not a candidate for an endovascular procedure, traditional surgery may be your best option. Your vein specialists’ team will discuss these options with you in detail if they are considered appropriate for your condition.
Sources:
Venous compression syndromes: clinical features, imaging findings and management
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Since 1997, Vein Specialists of the South has helped thousands of patients like you with varicose veins, spider veins, and leg swelling. Dr. Kenneth Harper is a leader in vein health is a Diplomat of the American Board of Surgery and the American Vein and Lymphatic Medicine. Terri Harper, MSN, FNP-C, is a renowned educator in the field of cosmetic sclerotherapy. Our dedicated nurse injectors have been trained by the best.
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