Advertisement

IR Playbook pp 163-169 | Cite as

Pelvic Congestion Syndrome

  • Nicole A. Keefe
  • Anne Roberts
Chapter

Abstract

Pelvic congestion syndrome is caused by pelvic or vulvar varicosities that may lead to chronic pelvic pain in women. Symptoms are typically described as dull pelvic pain which worsens with prolonged standing. Ovarian vein embolization can provide a minimally invasive means of relieving pain and improving quality of life.

Keywords

Pelvic congestion syndrome Chronic pelvic pain Varicosities Ovarian veins Venous incompetence Transcatheter embolization Ovarian vein embolization 

References

  1. 1.
    Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141–7.PubMedGoogle Scholar
  2. 2.
    Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006;6:177.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 1996;87(3):321–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Daniels J, Gray R, Hills RK, Latthe P, Buckley L, Gupta J, et al. Laparoscopic uterosacral nerve ablation for alleviating chronic pelvic pain: a randomized controlled trial. JAMA. 2009;302(9):955–61.CrossRefPubMedGoogle Scholar
  5. 5.
    O'Brien MT, Gillespie DL. Diagnosis and treatment of the pelvic congestion syndrome. J Vasc Surg Venous Lymphat Disord. 2015;3(1):96–106.CrossRefPubMedGoogle Scholar
  6. 6.
    Liddle AD, Davies AH. Pelvic congestion syndrome: chronic pelvic pain caused by ovarian and internal iliac varices. Phlebology. 2007;22(3):100–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Borghi C, Dell'Atti L. Pelvic congestion syndrome: the current state of the literature. Arch Gynecol Obstet. 2016;293(2):291–301.CrossRefPubMedGoogle Scholar
  8. 8.
    Hobbs JT. The pelvic congestion syndrome. Br J Hosp Med. 1990;43(3):200–6.PubMedGoogle Scholar
  9. 9.
    Ganeshan A, Upponi S, Hon LQ, Uthappa MC, Warakaulle DR, Uberoi R. Chronic pelvic pain due to pelvic congestion syndrome: the role of diagnostic and interventional radiology. Cardiovasc Intervent Radiol. 2007;30(6):1105–11.CrossRefPubMedGoogle Scholar
  10. 10.
    Perrin MR, Labropoulos N, Leon LR Jr. Presentation of the patient with recurrent varices after surgery (REVAS). J Vasc Surg. 2006;43(2):327–34. discussion 334CrossRefPubMedGoogle Scholar
  11. 11.
    Asciutto G, Asciutto KC, Mumme A, Geier B. Pelvic venous incompetence: reflux patterns and treatment results. Eur J Vasc Endovasc Surg. 2009;38(3):381–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Koo S, Fan CM. Pelvic congestion syndrome and pelvic varicosities. Tech Vasc Interv Radiol. 2014;17(2):90–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Nicholson T, Basile A. Pelvic congestion syndrome, who should we treat and how? Tech Vasc Interv Radiol. 2006;9(1):19–23.CrossRefPubMedGoogle Scholar
  14. 14.
    Kennedy A, Hemingway A. Radiology of ovarian varices. Br J Hosp Med. 1990;44(1):38–43.PubMedGoogle Scholar
  15. 15.
    Pandey T, Shaikh R, Viswamitra S, Jambhekar K. Use of time resolved magnetic resonance imaging in the diagnosis of pelvic congestion syndrome. J Magn Reson Imaging. 2010;32(3):700–4.CrossRefPubMedGoogle Scholar
  16. 16.
    Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases:clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5 Suppl):2S–48S.CrossRefPubMedGoogle Scholar
  17. 17.
    Ahlberg NE, Bartley O, Chidekel N. Circumference of the left gonadal vein. An anatomical and statistical study. Acta Radiol Diagn (Stockh). 1965;3(6):503–12.CrossRefGoogle Scholar
  18. 18.
    Farquhar CM, Rogers V, Franks S, Pearce S, Wadsworth J, Beard RW. A randomized controlled trial of medroxyprogesterone acetate and psychotherapy for the treatment of pelvic congestion. Br J Obstet Gynaecol. 1989;96(10):1153–62.CrossRefPubMedGoogle Scholar
  19. 19.
    Rundqvist E, Sandholm LE, Larsson G. Treatment of pelvic varicosities causing lower abdominal pain with extraperitoneal resection of the left ovarian vein. Ann Chir Gynaecol. 1984;73(6):339–41.PubMedGoogle Scholar
  20. 20.
    Gargiulo T, Mais V, Brokaj L, Cossu E, Melis GB. Bilateral laparoscopic transperitoneal ligation of ovarian veins for treatment of pelvic congestion syndrome. J Am Assoc Gynecol Laparosc. 2003;10(4):501–4.CrossRefPubMedGoogle Scholar
  21. 21.
    Smith PC. The outcome of treatment for pelvic congestion syndrome. Phlebology. 2012;27(Suppl 1):74–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Edwards RD, Robertson IR, MacLean AB, Hemingway AP. Case report: pelvic pain syndrome--successful treatment of a case by ovarian vein embolization. Clin Radiol. 1993;47(6):429–31.CrossRefPubMedGoogle Scholar
  23. 23.
    Kwon SH, JH O, Ko KR, Park HC, Huh JY. Transcatheter ovarian vein embolization using coils for the treatment of pelvic congestion syndrome. Cardiovasc Intervent Radiol. 2007;30(4):655–61.CrossRefPubMedGoogle Scholar
  24. 24.
    Venbrux AC, Chang AH, Kim HS, Montague BJ, Hebert JB, Arepally A, et al. Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain. J Vasc Interv Radiol. 2002;13(2 Pt 1):171–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Kim HS, Malhotra AD, Rowe PC, Lee JM, Venbrux AC. Embolotherapy for pelvic congestion syndrome: long-term results. J Vasc Interv Radiol. 2006;17(2 Pt 1):289–97.CrossRefPubMedGoogle Scholar
  26. 26.
    Lopez AJ. Female pelvic vein embolization: indications, techniques, and outcomes. Cardiovasc Intervent Radiol. 2015;38(4):806–20.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Yamasaki W, Kakizawa H, Ishikawa M, Date S, Tatsugami F, Terada H, et al. Migration to the pulmonary artery of nine metallic coils placed in the internal iliac vein for treatment of giant rectal varices. Acta Radiol Short Rep. 2012;1(6):1–4.CrossRefGoogle Scholar
  28. 28.
    Freedman J, Ganeshan A, Crowe PM. Pelvic congestion syndrome: the role of interventional radiology in the treatment of chronic pelvic pain. Postgrad Med J. 2010;86(1022):704–10.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nicole A. Keefe
    • 1
  • Anne Roberts
    • 2
  1. 1.Department of Radiology and Medical Imaging, Diagnostic and Interventional RadiologyUniversity of Virginia Health SystemCharlottesvilleUSA
  2. 2.Department of RadiologyUC San Diego Medical CenterLa JollaUSA

Personalised recommendations