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Clarksville’s Dr. Stephen Daugherty presents at the American Venous Forum

Veincare Centers of TennesseeClarksville, TN – Dr. Stephen Daugherty, the medical director of VeinCare Centers of Tennessee in Clarksville, Tennessee, presented his leading clinical experience treating pelvic venous congestion syndrome at the annual meeting of the American Venous Forum (AVF) on February 25th.

The American Venous Forum is an organization of physicians, mostly academic vascular surgeons, with interests in venous disorders. Dr. Daugherty was the first American to report a series of patients with pelvic congestion syndrome (PCS) due to compression of the veins of the pelvis two years ago when he previously reported at the AVF meeting.

Dr. Stephen Daugherty
Dr. Stephen Daugherty

His most recent report is thought to be the most comprehensive information available regarding chronic pelvic pain in women due to obstruction of pelvic veins.

Previously, most pelvic pain and pain with intercourse (dyspareunia), associated with a venous disorder was thought to be due to an enlarged vein to the ovary allowing blood to collect in the veins of the pelvis. Obstruction of the iliac vein in the pelvis was known to cause leg pain and leg swelling, but the association with deep pelvic pain and dyspareunia was rarely appreciated.

About 10 years ago, Dr. Daugherty began to see women with chronic pelvic pain and leg pain whose pelvic symptoms resolved when they were treated with stenting of the iliac vein for the leg symptoms. Previously, the standard gynecologic work-up had failed to identify the cause of the chronic pelvic pain.

“As our awareness of the pelvic symptoms and our ability to visualize the areas of compression on the veins with sophisticated venous ultrasound and other imaging studies improved, we identified more of these patients with chronic pelvic pain associated with compression of the iliac vein between an artery and the backbone. We treated these with stents just as we had been treating the same compressed veins for relief of leg symptoms since 2002. The results were dramatic with complete or near-complete resolution of pelvic pain and pain with intercourse in nearly all of the patients. Thus far, the results have remained excellent, Daugherty says.”

Dr. Daugherty began reporting findings at major national and international meetings two years ago and his expanded report to the AVF reviewed the results of treating 33 patients with stents in the left common iliac vein to open the outflow of venous blood from the leg and pelvis back to the heart.

The median pain score for pelvic pain and for dyspareunia reported by the patients on a scale of 0 to 10 (10 meaning the worst pain one can imagine) was 8 before treatment. The median score reported at the most recent follow-up with each patient (ranging to as long as 83 months) was 1.

Chronic pelvic pain lasting more than 6 months may be caused by a variety of problems. Endometriosis (growth of the type of cells that normally line the womb but which may grow in other areas of the pelvis outside the womb), ovarian cysts, and hormone-related problems may cause pelvic pain, but venous abnormalities may comprise up to 30% of cases of chronic pelvic pain.

A few of the patients have pelvic pain due to blood running down an enlarged ovarian vein, but Dr. Daugherty is seeing more patients who have pain from compression of the iliac vein.

Dr. Daugherty was notified recently that his manuscript from a report to the International Phlebology Union in 2013 has been accepted for publication by the Journal of Vascular Surgery: Venous and Lymphatic Disorders in the near future. The JVS:VLD is a peer-reviewed publication and is widely thought to be the most academically rigorous journal publishing scholarly reports of vascular diagnosis and treatment.

Patients who have chronic pelvic pain or deep pelvic pain with intercourse who have undergone a thorough gynecologic evaluation without a solution may benefit from evaluation of the veins of the pelvis. Most of these patients also experience pain or swelling in the left leg as well.

The initial office evaluation is followed with a thorough abdominal/pelvic venous ultrasound exam by very skilled Registered Vascular Technologists in the VeinCare Centers of Tennessee office which usually answers the question of a venous disorder. If stenting of an obstruction is appropriate, it is done through a needle stick in the groin with X-ray and ultrasound guidance. Recovery is quick and quality of life usually is dramatically changed for these patients.

Potential patients should discuss their pelvic pain with their gynecologist and, if the gynecologist does not need to do any additional evaluation, patients may make an appointment with Dr. Daugherty and his nurse practitioner, Pamela Beasley, by calling 931.551.8991.

Visit www.TennesseeVeinCare.com to review our experience and credentials in management of venous disorders which are unrivalled in Tennessee. Website pages include coverage of pelvic venous congestion, pelvic pain, and venous stenting

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