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Pelvic congestion syndrome


Authors: M. Holý
Authors‘ workplace: Interní oddělení Nemocnice České Budějovice, a.  s.
Published in: Kardiol Rev Int Med 2014, 16(4): 321-329
Category: Internal Medicine

Overview

Pelvic congestion is a special form of chronic venous disease in women. This is defined as s syndrome which includes chronic pelvic pain, perineal discomfort, difficulties of micturition, and post‑coital pain in association with ovarian and/ or pelvic vein reflux. It may cause vulvar, perineal, gluteal and lower extremity varices. There is a close relation between symptomatic pelvic varices and renal nutcracker syndrome. Duplex ultrasound of abdominal, pelvic and lower extrem­ity veins and vulvoprineal region is the cardinal method of non‑invasive examination. MRI Venography is a highly sensitive technique for evaluating pelvic congestion. It may be used as a screening method or in cases of ambiguous sonographic findings and doubts. Pharmaceutical treatment options are limited, and therapy is based on venoactive drugs. Endovascular intervention –  ovarian/ iliac veins embolisation therapy and ilio‑ caval and renal venous stenting –  becomes the first line of treatment for women with severe symptoms, which are resistant to conservative approaches.

Keywords:
chronic pelvic pain –  varicose veins –  pelvic congestion –  renal congestion –  anatomy –  duplex ultrasound –  dia­gnostic criteria –  embolisation therapy –  renal venous stenting


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