Case Series
The seven patients treated at our institution appear in Table 1 as “present cases.” All seven complained of long-term severe left flank and abdominal pain. Other symptomatology included hematuria of unknown etiology and pelvic congestion symptoms. These patients had been treated for non-specific pain. Many were on long term opioid therapy.
There were six females and one male. Age ranged from 19 to 58. Our initial workup consisted of CT venography, which showed LRV enlargement in all seven patients. IVUS was subsequently used in all seven patients and showed LRV diameter and degree of compression supportive of NCS.
One patient underwent endovascular intervention with stenting. One had gonadal vein transposition. Three underwent robot-assisted laparoscopic LRV PTFE cuff placement. One had LRV bypass with PTFE. One had LRV transposition (Figure 2). All patients reported reduced postoperative pain. Some had lingering mild discomfort but opioid pain medications were discontinued in all seven patients. They reported significant improvements in quality of life and symptoms at follow up visits.