Anatomical variations of the ovarian veins and their clinical implications: a meta-analysis.

BACKGROUND

The ovarian veins (OVs) are paired vessels that drain deoxygenated blood from the ovaries, fallopian tubes, and adjacent pelvic structures. The objective of this study was to systematically synthesize cadaveric and imaging-based data to describe the anatomy, variations, and clinical relevance of the OVs.

MATERIALS AND

METHODS

For this meta-analysis, a systematic literature search was carried out to identify all studies concerning the anatomy of the ovarian veins. Searches were performed in major medical databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library.

RESULTS

A total of 35 studies were included in this meta-analysis. The overall mean diameter of the OV was estimated at 4.88 mm (SE = 0.24). The diameter of the right OV reached 4.44 mm (SE = 0.28), while the left OV measured 4.99 mm (SE = 0.34). The pooled prevalence of valves in the ovarian veins was calculated at 91.93% (95% CI: 83.32-97.79%). Competent valves were found in 72.16% of cases (95% CI: 58.72-83.89%), while incompetent valves were present in 27.84% (95% CI: 16.11-41.28%). On the right side, a double OV was present in 1.00% of specimens (95% CI: 0.00-3.08%). On the left, this variation occurred slightly more frequently, with a pooled prevalence of 2.08% (95% CI: 0.43-4.72%).

CONCLUSIONS

This meta-analysis highlights critical anatomical and clinical features of the ovarian veins. The left OV is wider and more frequently incompetent than the right, supporting the left-sided predominance of pelvic congestion syndrome. Drainage patterns confirm classical anatomy - right OV to inferior vena cava, left OV to left renal vein - but rare variants must be considered during interventions. OV duplication, though rare, poses a risk of incomplete embolization if unrecognized. These findings underscore the need for side-specific imaging and thorough anatomical evaluation to improve diagnosis, embolization outcomes, and surgical planning in pelvic venous disorders.