scholarly journals Predicting pelvic congestion syndrome: Concomitant pelvic pain diagnoses do not affect venography or embolization outcomes

2021 ◽  
Vol 11 ◽  
pp. 61
Author(s):  
Jared Macher ◽  
Akshaar Brahmbhatt ◽  
Anisha Shetty ◽  
Komal Chughtai ◽  
Timothy Baran ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Pelvic Pain ◽  
Final Analysis ◽  
Clinical History ◽  
Complete Response ◽  
Technical Failure ◽  
Similar Treatment ◽  
Pelvic Congestion Syndrome ◽  
Presenting Symptoms ◽  
Pelvic Congestion

Objectives: Pelvic congestion syndrome (PCS) is a challenging diagnosis to make secondary to nonspecific presenting symptoms and imaging findings. This retrospective review aims to discern predictive factors which can guide the decision to perform catheter-based venography and prognosticate outcomes. Material and Methods: A retrospective analysis of patients who underwent catheter venography for PCS between January 2014 and December 2019 was performed. Multiple factors, including patient demographics, clinical history, pre-procedural imaging, venographic findings, and treatment outcomes 180 days post-procedure, were included in the analysis. Venographic findings were used to separate patients into two groups (positive or negative), with these factors compared across groups. Regression analysis controlled for the confounding effects of age and body mass index (BMI). Treated subjects were separated based on outcome (partial, no response, complete response, or technical failure), and comparisons were performed. Results: Eighty patients were included in the initial analysis. Two patients were excluded due to prior embolization or portal hypertension. Seventy-eight patients were included in the final analysis. Sixty-two patients had positive findings, and 16 had no venographic findings to suggest PCS. A history of prior pregnancy was a significant predictor of positive venographic results (odds ratio = 5.99, P = 0.007). BMI was significantly lower in those with positive venographic results (P = 0.047). Presence of concomitant diagnoses did not affect venographic findings or treatment outcomes. No factors predicted treatment outcomes. Five of the treated patients had subsequent successful pregnancies. Conclusion: A lower BMI supports the decision to perform venography for suspected PCS. In addition, patients who carried concomitant potentially confounding diagnoses for chronic pelvic pain were found to have similar rates of venographic findings suggesting PCS, as well as similar treatment outcomes.

Treatment Outcomes of Endovascular Embolization for Pelvic Congestion Syndrome

2018 ◽  
Vol 51 ◽  
pp. 282-283
Author(s):  
William Wilson ◽  
Lyssa Ochoa ◽  
Jenny J. Lee ◽  
Mathew Cheung ◽  
Peter H. Lin
Keyword(s):  
Treatment Outcomes ◽  
Endovascular Embolization ◽  
Pelvic Congestion Syndrome ◽  
Pelvic Congestion

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.

Clinical outcome after treatment of pelvic congestion syndrome: Sense and nonsense

2015 ◽  
Vol 30 (1_suppl) ◽  
pp. 73-80 ◽  
Author(s):  
MH Meissner ◽  
K Gibson
Keyword(s):  
Pelvic Pain ◽  
Transcatheter Embolization ◽  
Response To Treatment ◽  
Symptom Improvement ◽  
Inadequate Response ◽  
Pelvic Congestion Syndrome ◽  
Pain Scores ◽  
Embolic Agents ◽  
Vein Resection ◽  
Pelvic Congestion

Chronic pelvic pain accounts for approximately 10% of outpatient gynecologic visits and among the varied causes, pelvic congestion syndrome is second only to endometriosis in frequency. Manifestations may include pelvic pain, dyspareunia, dysuria, and dysmenorrhea as well as external varices and a number of psychosocial symptoms. Although a variety of treatments have been proposed—including pharmacologic ovarian suppression, hysterectomy with or without oophorectomy, and ovarian vein resection—transcatheter embolization is the least invasive and most efficacious management option. Complete or partial symptom improvement has been reported in 68.2–100% of patients and there has been a consistent reduction in visual analog pain scores after treatment. Based upon these results, recommendation of either pharmacotherapy or other surgical procedures is difficult to justify. However, it is also clear that 6–31.8% of patients do not get substantial relief from pelvic venous embolization. Potential explanations for an inadequate response to treatment include patient variability, procedural variability, and inadequate outcome measures. The latter are particularly important and future investigation should focus on the development of disease-specific quality of life measures as well as identifying those aspects of the procedure, such as choice of embolic agents and extent of embolization, associated with the best clinical outcomes.

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.

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