Pelvic congestion syndrome

Czech version

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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