Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management

Darci Phillips; Amy R Deipolyi; Richard L Hesketh; Mehran Midia; Rahmi Oklu

doi:10.1016/j.jvir.2014.01.030

Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management

J Vasc Interv Radiol. 2014 May;25(5):725-33. doi: 10.1016/j.jvir.2014.01.030.

Authors

Darci Phillips¹, Amy R Deipolyi², Richard L Hesketh³, Mehran Midia⁴, Rahmi Oklu⁵

Affiliations

¹ Harvard Medical School, and Department of Imaging, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.
² Harvard Medical School, and Department of Imaging, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114; Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.
³ West Middlesex University Hospital, London, United Kingdom.
⁴ Division of Interventional Radiology, McMaster University Medical Center, Hamilton, Ontario, Canada.
⁵ Harvard Medical School, and Department of Imaging, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114; Division of Interventional Radiology, Massachusetts General Hospital, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114. Electronic address: roklu@mgh.harvard.edu.

PMID: 24745902
DOI: 10.1016/j.jvir.2014.01.030

Abstract

Pelvic congestion syndrome is associated with pelvic varicosities that result in chronic pelvic pain, especially in the setting of prolonged standing, coitus, menstruation, and pregnancy. Although the underlying pathophysiology of pelvic congestion syndrome is unclear, it probably results from a combination of dysfunctional venous valves, retrograde blood flow, venous hypertension, and dilatation. Asymptomatic women may also have pelvic varicosities, making pelvic congestion syndrome difficult to diagnose. This article explores the etiologies of pain, use of imaging techniques, and clinical management of pelvic congestion syndrome. Possible explanations for the spectrum of pain among women with pelvic varicosities are also discussed.

Publication types

Review

MeSH terms

Chronic Pain / diagnosis
Chronic Pain / therapy
Diagnostic Imaging / methods*
Embolization, Therapeutic / methods*
Female
Humans
Pelvic Pain / diagnosis*
Pelvic Pain / therapy*
Treatment Outcome
Varicose Veins / diagnosis*
Varicose Veins / therapy*