scholarly journals Pelvic congestion syndrome: historical aspects and a modern view on the problem (a literature review)

2021 ◽  
Vol 23 (5) ◽  
pp. 723-729
Author(s):  
A. O. Nykonenko ◽  
B. S. Havrylenko
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Venous Stasis ◽  
Difficult Patient ◽  
Pelvic Congestion Syndrome ◽  
Detailed Medical History ◽  
Varicose Disease ◽  
Pelvic Congestion

Pelvic congestion syndrome is a relatively recent, but actual and separate nosological form. Pelvic varicocele is a form of varicose disease, which is increasingly regarded as the main cause of chronic pelvic pain in women with various clinical manifestations. A woman with chronic pelvic pain is a difficult patient with combative behavior, who contacts with physicians in various specialties. There are many causes of chronic pelvic pain, but pelvic congestion syndrome has a special place. In recent years, in addition to widespread use of diagnostic radiology, the relevance of this pathology is beyond any doubt. The aim of the study was to summarize and present literature data on the etiology, pathogenesis, clinical manifestations, diagnosis and treatment of pelvic congestion syndrome by analyzing the literature data. Materials and methods. A non-systematic review was conducted using PubMed, Web of Science, Google and Google Scholar databases. The review included free full-text articles published between 1974 and 2021 using key words: pelvic congestion syndrome, pelvic varices, pelvic venous disorders, pelvic varicocele, pelvic venous stasis, chronic pelvic pain, gonadal veins, ovarian veins, vena ovarica, Nutcracker syndrome, May–Thurner syndrome. Conclusions. Pelvic congestion syndrome is still a rarely diagnosed pathology in patients with chronic pelvic pain. Detailed medical history, physical examination as well as maintaining diagnostic algorithm would allow the disease to be diagnosed correctly and timely. The choice of method for surgical intervention is a key point in the treatment of patients with pelvic congestion syndrome, but today there are no criteria for the choice of one, so the problem is far from being resolved and requires further study and research.

Compression treatment of pelvic congestion syndrome

2017 ◽  
Vol 33 (6) ◽  
pp. 418-424 ◽  
Author(s):  
SG Gavrilov ◽  
AV Karalkin ◽  
OO Turischeva
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Clinical Manifestations ◽  
Class Ii ◽  
Emission Computed Tomography ◽  
Compression Stockings ◽  
Pelvic Congestion Syndrome ◽  
Compression Treatment ◽  
Positive Effect ◽  
Pelvic Congestion

Aim To study the influence of compression treatment on clinical manifestations and venous hemodynamics of the pelvis in patients with pelvic congestion syndrome. Materials and methods A prospective study of the various options and modes of compression treatment was carried out and included 74 patients with pelvic congestion syndrome in 2008–2015. The patients were divided into three groups. The first group consisted of 48 patients with symptoms of pelvic congestion syndrome and chronic pelvic pain. They used Class II compression shorts. In the second group, there were 14 patients with pelvic congestion syndrome, vulvar varicosities without pelvic pain. They used Class II compression shorts and stockings. In the third group, 12 women with pelvic congestion syndrome and chronic pelvic pain used only the Class II compression stockings. The treatment continued for 14 days. A clinical criterion was the change of severity of chronic pelvic pain. The evaluation of the treatments has been performed using radionuclide venography and emission computed tomography with labeled in vivo red blood cells. Results Group 1: The compression shorts had a positive effect on the disease in 81.3% of patients. Chronic pelvic pain decreased from 6.4 ± 1.6 to 1.2 ± 0.7 points. The coefficient of pelvic congestion syndrome (Cpcs) decreased from 1.73 ± 0.32 to 1.12 ± 0.27 (p < 0.05). In 18.8% of patients, no positive effect was observed. Group 2: The results of radionuclide venographyshowed accelerating outflow of blood from the lower limbs and reduction of insufficiency of perforating veins. Mean radionuclide transit time decreased in all patients in the tendon, muscle pump parts, popliteal vein and was respectively: 23.6 ± 2.2 s, 29.6 ± 3.4 s, 32.3 ± 4.2 s and after treatment 16.4 ± 3.1 s, 22.1 ± 2.5 s, 25.7 ± 1.9 s (p < 0.05). Group 3: The use of compression stockings class II on the clinical manifestations of pelvic congestion syndrome in the patients. Cpcs also remained unchanged. Conclusion Research has shown the efficiency of class II compression shorts in the treatment of patients with isolated extension of intrapelvic venous plexuses. Class II compression stockings do not have any impact on the clinical manifestations of pelvic congestion syndrome.

Sensitivity and specificity of clinical findings for the diagnosis of pelvic congestion syndrome in women with chronic pelvic pain

2017 ◽  
Vol 33 (5) ◽  
pp. 303-308 ◽  
Author(s):  
Ana Lucia Herrera-Betancourt ◽  
Juan Diego Villegas-Echeverri ◽  
Jose Duván López-Jaramillo ◽  
Jorge Darío López-Isanoa ◽  
Jorge Mario Estrada-Alvarez
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Diagnostic Performance ◽  
Abdominal Mass ◽  
Clinical Score ◽  
Trigger Points ◽  
Clinical Findings ◽  
Diagnostic Tools ◽  
Pelvic Congestion Syndrome ◽  
Pelvic Congestion

Background Pelvic congestion syndrome is among the causes of pelvic pain. One of the diagnostic tools is pelvic venography using Beard’s criteria, which are 91% sensitive and 80% specific for this syndrome. Objective To assess the diagnostic performance of the clinical findings in women diagnosed with pelvic congestion syndrome coming to a Level III institution. Methods Descriptive retrospective study in women with chronic pelvic pain taken to transuterine pelvic venography at the Advanced Gynecological Laparoscopy and Pelvic Pain Unit of Clinica Comfamiliar, between August 2008 and December 2011, analyzing social, demographic, and clinical variables. Results A total of 132 patients with a mean age of 33.9 years. Dysmenorrhea, ovarian points, and vulvar varices have a sensitivity greater than 80%, and the presence of leukorrhea, vaginal mass sensation, the finding of an abdominal mass, abdominal trigger points, and positive pinprick test have a specificity greater than 80% when compared with venography. Conclusion This study may be considered as the first to evaluate the diagnostic performance of the clinical findings associated with pelvic congestion syndrome in a sample of the Colombian population. In the future, these findings may be used to create a clinical score for the diagnosis of this condition.

scholarly journals Pelvic congestion syndrome as a cause of chronic pelvic pain

2021 ◽  
Vol 15 (4) ◽  
pp. 451-460
Author(s):  
N. Yu. Novikova ◽  
V. I. Tsibizova ◽  
P. D. Puzdriak ◽  
E. V. Komlichenko ◽  
I. G. Tsnobiladze ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Varicose Veins ◽  
Venous Pressure ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Clinical Criteria ◽  
Pelvic Congestion Syndrome ◽  
Pelvic Congestion

Altered pelvic venous circulation, which may occur due to pelvic venous congestion and varicose veins of the vulva, may be among the causes for developing chronic pelvic pain syndrome. Pelvic congestion syndrome (PCS) is characterized by chronic discomfort in the pelvic area, which may be aggravated during coitus or acquire orthostatic position, and result in severe dysfunction of the pelvic organs. Varicose veins of the vulva develop due to obstruction of the veins, increased venous pressure, and venous insufficiency in the pelvis. Varicose veins may be isolated or associated with varicose veins of the lower extremities. The diagnosis and treatment of such patients are limited by the lack of definitive clinical criteria for early diagnostics, which were discussed in the current study.

Pelvic congestion syndrome: chronic pelvic pain caused by ovarian and internal iliac varices

2007 ◽  
Vol 22 (3) ◽  
pp. 100-104 ◽  
Author(s):  
A D Liddle ◽  
A H Davies
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Significant Proportion ◽  
Duplex Ultrasound ◽  
Childbearing Age ◽  
Pelvic Congestion Syndrome ◽  
Non Invasive ◽  
Internal Iliac ◽  
Mechanical Factors ◽  
Pelvic Congestion

Chronic pelvic pain is a common and disabling condition affecting women of childbearing age. A specific diagnosis for the condition is often difficult, and referred pain from the abdominal viscera, neurogenic and psychogenic factors have all been implicated, as have pelvic conditions such as endometriosis, pelvic inflammatory disease and ovarian cysts; no diagnosis is made in 60% of patients. Pelvic congestion syndrome (PCS), the presence of varices of the pelvic veins, has been shown to be the underlying aetiology in a significant proportion of patients with chronic pelvic pain; the development of these varices is caused by a combination of endocrine and mechanical factors. Given the positional nature of these varices, they are rarely diagnosed with conventional methods such as B-mode ultrasound and diagnostic laparoscopy. Diagnosis is best made with selective ovarian venography, although newer, non-invasive methods such as magnetic resonance imaging and duplex ultrasound are increasingly gaining favour. Pelvic varices are eminently treatable, either using ovarian suppression or by the ligation or embolization of the pelvic veins.

A standardized ultrasound approach to pelvic congestion syndrome

2016 ◽  
Vol 32 (9) ◽  
pp. 608-619 ◽  
Author(s):  
Nicos Labropoulos ◽  
Patrick T. Jasinski ◽  
Demetri Adrahtas ◽  
Antonios P. Gasparis ◽  
Mark H. Meissner
Keyword(s):  
Pelvic Pain ◽  
Gold Standard ◽  
Chronic Pelvic Pain ◽  
Common Cause ◽  
Pelvic Congestion Syndrome ◽  
The Past ◽  
Imaging Approach ◽  
Diagnostic Modalities ◽  
The Many ◽  
Pelvic Congestion

Pelvic congestion syndrome is one of the many causes of chronic pelvic pain and is often diagnosed based on exclusion of other pathologies. Over the past decades, pelvic congestion syndrome was recognized to be a more common cause of chronic pelvic pain. Multiple diagnostic modalities including pelvic duplex ultrasonography, transvaginal ultrasonography, computed tomography, and magnetic resonance were studied. In the current literature, selective ovarian venography, an invasive imaging approach, is believed to be the gold standard for diagnosing pelvic congestion syndrome.

scholarly journals Pelvic congestion syndrome

Mediscope ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 33-35
Author(s):  
Razia Sultana ◽  
Rowshan Ara Begum ◽  
Ferdousi Begum
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Premenopausal Women ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Standing Position ◽  
Pelvic Congestion Syndrome ◽  
History Of ◽  
One Year ◽  
Pelvic Congestion

Chronic pelvic pain is a common gynecological problem with many causes and may account for approximately 10% outpatient gynecological visit. Pelvic Congestion Syndrome (PCS) is defined as a condition characterized by congestion of the pelvic veins visible on selective ovarian venography in multiparous premenopausal women with a history of chronic pelvic pain for more than six months. We report a case of PCS in 35 years old multiparous lady complaining of chronic pelvic pain for one year. The pain was worsened by sitting and standing position. Other general symptoms were present such as dysmenorrhea, rectal discomfort and urinary frequency. On examination patient was depressed, there was abdominal and pelvic tenderness. Pelvic ultrasound and Doppler examination showed dilated and tortuous ovarian veins and dilated tortuous arcuate veins in the myometrium. An ovarian cyst was present and uterus was enlarged. In this case total abdominal hysterectomy was done although ideal treatment for PCS is ovarian vein embolisation by interventional radiology which is not available in our country. DOI: http://dx.doi.org/10.3329/mediscope.v1i1.21635 Mediscope Vol. 1, No. 1: 2014, Pages 33-35

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