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Pelvic congestion syndrome: the current state of the literature

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Abstract

Purpose

Pelvic congestion syndrome is an uncommon poorly understood and frequently misdiagnosed disorder of the pelvic venous circulation, which causes chronic pelvic pain in women in premenopausal age. This condition has typical features, such as pelvic varicosities, pelvic pain worsened by prolonged standing, coitus, menstruation, and pregnancy.

Methods

The precise etiology of this syndrome remains uncertain, and it is probably multifactorial. Valvular insufficiency, venous obstruction, and hormones all may play a role in the development of congestion of the pelvic veins.

Results

Pelvic pain and venous varices are often both present in premenopausal women, but not necessarily causally related. Furthermore, incompetent and dilated pelvic veins are a common finding in asymptomatic women. As such, it is challenging but important to determine which patients have chronic pelvic pain specifically related to pelvic congestion syndrome in order to treat them properly.

Conclusions

Once the syndrome has been accurately diagnosed, medical, surgical, or minimally invasive endovascular treatments can improve symptoms in a high percentage of cases. This updated nonsystematic review of the literature explores the pathophysiology, clinical features, diagnostic investigations, and treatment option of this complex condition that affects young women with considerable implications for their daily social and psychological condition.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, S. Anna University Hospital, Ferrara, Italy

    Chiara Borghi

  2. Department of Urology, S. Anna University Hospital, 8 A. Moro Street, 44124, Cona, FE, Italy

    Lucio Dell’Atti

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  1. Chiara Borghi
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  2. Lucio Dell’Atti
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Correspondence to Lucio Dell’Atti.

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The manuscript does not contain clinical studies. Patient gave her consent for publication of radiologic images.

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Borghi, C., Dell’Atti, L. Pelvic congestion syndrome: the current state of the literature. Arch Gynecol Obstet 293, 291–301 (2016). https://doi.org/10.1007/s00404-015-3895-7

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