Ovarian varices in healthy female kidney donors: incidence, morbidity, and clinical outcome

Abstract

Objective: Kidney donation is associated with ligation of the ovarian vein and is comparable to ovarian vein embolization. We evaluated the incidence, morbidity, and clinical outcome of ovarian varices in healthy female kidney donors before and 6 months after nephrectomy.

Materials and methods: Between 1994 and 2001, 273 healthy female kidney donors underwent preoperative abdominal aortography. The study group consisted of 27 women (9.9%) in whom retrograde flow in an incompetent left ovarian vein was noted during the venous phase of imaging. All patients underwent left nephrectomy with left ovarian vein ligation. Only women with retrograde flow in the left ovarian vein were asked to complete a questionnaire about the incidence and intensity of pelvic pain before and 6 months after nephrectomy.

Results: Twenty-two of the 27 left-kidney donors with retrograde flow in the ovarian vein were available for follow-up. Thirteen (59%) of those 22 reported chronic pelvic pain. After nephrectomy, the pelvic pain completely resolved in seven (54%), improved in three (23%), and persisted in three (23%).

Conclusion: Our study found a 9.9% prevalence of ovarian varices in the general population. Our findings suggest that more than half (59%) the patients with ovarian varices have pelvic congestion syndrome and that most (77%) of them might benefit from ovarian vein embolization or ligation.