Interventional Therapy of Pelvic Venous Disorders (PeVD)

Abstract

Background Pelvic venous disorders (PeVD) are an underdiagnosed cause of chronic pelvic pain in women. They are caused by venous insufficiency of the pelvic or ovarian veins, leading to the development of mainly periuterine and periovarian varices. It is a progressive disease if left untreated and can cause swelling, dyspareunia, dysmenorrhea, and other symptoms, some non-specific, that affect the patient’s quality of life. Interventional therapies are a central component of the treatment of PeVD, with a variety of techniques available for both diagnosis and treatment. Method This review provides an overview of the pathophysiologic background, diagnosis, and, most importantly, interventional treatment options for PeVD. Results There is a lack of standardized nomenclature and internationally accepted diagnostic criteria for PeVD as well as randomized controlled trials demonstrating clinical success. However, in clinical trials, endovascular therapy for PeVD has been shown to be safe and effective. This review presents the various interventional techniques for the treatment of PeVD, including embolization, stenting, and sclerotherapy. Conclusion The importance of PeVD is receiving growing recognition. Recent advances, such as the development of the Symptoms-Varices-Pathophysiology (SVP) classification, provide an impetus to standardize nomenclature and are the first step toward systematizing disease management. Interventional therapies provide a safe and tailored minimally invasive treatment option for patients with PeVD. Key Points: Citation Format

Endometriosis and Pelvic Pain: Understanding Medical Treatment.

“…However, if pain relief is insufficient after three months of treatment, although it is difficult to define what is insufficient, diagnosis and treatment should be reconsidered. Other causes of pelvic pain might exist, such as venous congestion, adenomyosis, vascular pain such as Nutcrackers syndrome [56][57][58] and many others. Surgery is also an option for patients who do not tolerate the side effects of hormonal medications.…”