Indications for women:
NOTE: Ovarian vein incompetence is unusual in nullipara women (a women who has never borne a child) however, if the below signs and symptoms exist, an ovarian vein duplex ultrasound can be useful. Routinely, during this ultrasound examination, the left renal vein and the left common iliac vein will be assessed, to rule out external compression, namely, nutcracker syndrome and May Thurner syndrome.
- Varicose veins, primary or recurrent, originating from the pelvic and buttock region
- Heaviness in the pelvic region
- Urinary frequency and/or nocturia
- Pain on intercourse
- Painful, aching legs which can worsen during certain period in the menstrual cycle.
- Follow up CT, indicating dilated ovarian vein or the detection of pelvic varices, on a previous pelvic ultrasound
- Surveillance post ovarian vein intervention
Indications for Men:
- Varicose veins, primary or recurrent, originating from the pelvic and the buttock region
- A feeling of heaviness in the pelvic region
- Urinary frequency and/or nocturia
- Impotence
- Follow up CT, indicating dilated spermatic vein or the detection of pelvic varices, on a previous pelvic ultrasound
- Surveillance post ovarian vein intervention
Contraindications and limitations:
- Extreme abdominal girth
- Excessive abdominal gas
- Site trauma such as open wounds, surgical wounds/drains, or colostomy, in the scanning area
- Patients inability to hold their breath or suspend breathing for short periods of time
Patient preparation:
- 2 days prior to the ultrasound, it is advisable for the patient to refrain from eating fatty foods, fizzy drinks or any foods that create bowel irritability or gas. WHY? Gas in the bowel creates acoustic shadowing, on ultrasound imaging. Any vessels that sits in this shadow will not be seen, therefore cannot be assessed.
- PLUS, 2 days prior to the ultrasound, ensure adequate hydration; drinking 1500-2000ml of water per day, unless there is an underlying medical condition, that requires fluid restrictions. Please note: Coffee, tea and alcoholic drinks are dehydrating; these drinks are not included in the 1500-2000mls of water. WHY? Being hydrated increases the blood volumes which allows for improved visualisation of the veins plus, low blood sugar levels and dehydration can be associated with a vasovagal response (light headiness, or fainting), whilst standing. Nutrition and hydration can help reduce the risk of this occurring.
- On the day of the ultrasound, fast from food and water for a minimum of 6 hours, refrain from chewing gum and smoking. If medication is required, this can be taken with a small sip of water. WHY? Gas in the bowel creates acoustic shadowing, on ultrasound imaging. Any vessels that sits in this shadow will not be seen, therefore cannot be assessed.
PLEASE BRING RELEVANT, PREVIOUS DIAGNOSTIC REPORTS AND ULTRASOUND WORKSHEETS TO YOUR ULTRASOUND AND DOCTORS APPOINTMENT
What to wear:
Loose-fitting clothes, for example; elasticated skirt/pants/shorts and a loose-fitting top.
Ultrasound study technique:
Ultrasound is a non-invasive diagnostic study. The patient will lie on a bed, with the head of the bed slightly elevated for comfort. Ultrasound gel will be applied to the abdomen. An ultrasound probe will be run over the abdomen. Occasionally the sonographer may need to apply pressure to the abdomen to improve the visualisation of the veins, plus ask the patient to periodically, hold their breath, to accurately assess the spectral Doppler waveform velocities. This will be repeated with the patient standing, to increase the gravitational effect. This increases the hydrostatic pressure, in the venous system, enabling the ultrasonographer to accurately assess for the presence of venous incompetence (flow in the reversed direction. The flow in a normal ovarian vein travels towards the head, not away from the head). Images will be obtained, and the results, documented on a worksheet.
Ultrasound study time:
30 -45 minutes
Results:
A worksheet can be available, if requested. A formal written report will be available within 24 to 48 hours, following the ultrasound examination, Monday to Friday. If the ultrasound findings demonstrate pathology, which may require urgent attention, the referring Doctor will be notified ASAP following the completion of the ultrasound.