Pelvic Congestion Syndrome

Basile, Antonio; Failla, Giovanni; Gozzo, Cecilia

doi:10.1053/j.sult.2020.07.001

Cited by 14 publications

(12 citation statements)

References 42 publications

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“…It is difficult to establish whether unilateral embolization has a different result than a bilateral approach, as the studies and the opinions are heterogeneous and divergent [77]; however, it seems that there is no statistically significant difference in performing a unilateral or bilateral procedure, in terms of clinical outcome [77]. The clinical success of combined interventions on ovarian, internal iliac and varicose veins appears to be lower than for interventions limited to ovarian and iliac veins [85]. Finally, parity does not appear to be associated with difference in outcome in terms of clinical success in follow-up, regardless of the agent used [81].…”

Section: Clinical Results In Pelvic Congestion Syndromementioning

confidence: 99%

Liquid and Solid Embolic Agents in Gonadal Veins

Tiralongo

Distefano

Palermo

et al. 2021

JCM

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Male varicocele and pelvic congestion syndrome (PCS) are common pathologies with high predominance in young patients, having a high impact on the quality of life and infertility. Lately, the use of different endovascular embolization techniques, with various embolizing agents, shows good technical results and clinical outcomes. With the aim of presenting the “state of the art” of endovascular techniques for the treatment of male varicocele and PCS, and to discuss the performance of the different embolic agents proposed, we conducted an extensive analysis of the relevant literature and we reported and discussed the results of original studies and previous meta-analyses, providing an updated guide on this topic to clinicians and interventional radiologists. We have also underlined the technical aspects for the benefit of those who approach this type of interventional treatment. Our review suggests promising results in both the endovascular embolic treatment of male varicocele and PCS; for varicocele, a success rate of between 70% and 100% and a recurrence rate of up to 16% is reported, while for PCS it has been found that technical success is achieved in almost all cases of endovascular treatment, with a highly variable recurrence rate based on reports. Complications are overall rather rare and are represented by periprocedural pain, migration of embolic media and vascular perforations: severe adverse events have been reported very rarely.

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Section: Clinical Results In Pelvic Congestion Syndromementioning

confidence: 99%

Liquid and Solid Embolic Agents in Gonadal Veins

Tiralongo

Distefano

Palermo

et al. 2021

JCM

Self Cite

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“…Radiology referral or gynaecology referral may lead to CT/MRI perineal or vulvar varices, thought to be the result of obstruction to, or reflux of, the pelvic veins. Its aetiology is not fully understood (Cheema and Singh, 2020); however, as many as 30% of women with CPP can be affected (Basile et al, 2021). It is more common in women who have had more than two pregnancies, have concurrent varicosities of the lower limbs or have a history of polycystic ovarian syndrome.…”

Section: Ultrasoundmentioning

confidence: 99%

Chronic pelvic pain in women

Nicolson

Gillespie

2022

InnovAiT

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Chronic pelvic pain (CPP) is a common and complex condition. It affects up to 24% of women worldwide (1:6) and has a prevalence rate similar to asthma or back pain. The International Association for the study of Pain defines it as: ‘chronic or persistent pain perceived in structures related to the pelvis of either men or women. It is often associated with negative cognitive, behavioural, sexual, and emotional consequences as well as with symptoms suggestive of lower urinary tract, sexual, bowel, pelvic floor or gynaecological dysfunction.’ CPP lasts over 6 months and causes functional problems to the lives of sufferers.

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“…Unlike CT, MRI does not involve the use of radiation and can be used more safely in women of child-bearing age. Cross-sectional imaging allows detection of other pathologies such as abnormal uterine, endometriosis, gastrointestinal or musculoskeletal pathology or tumours [ 47 , 69 ]. Both contrast-enhanced MRA and non-contrast MRA sequences provide good sensitivity in diagnosing venous insufficiency [ 70 ] ( Figures 6 and 7 ).…”

Section: Diagnosismentioning

confidence: 99%

“…Venography still remains the gold standard for diagnosis of PCS. Since it is an invasive examination it should be reserved for patients who had prior non-invasive imaging, while interventional therapy is planned [ 60 , 69 , 81 ]. Selective ovarian and iliac catheter venography can be performed under local anaesthesia.…”

Section: Diagnosismentioning

confidence: 99%

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Comprehensive overview of the venous disorder known as pelvic congestion syndrome

2021

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Pelvic venous disorders (PeVD) also known as Pelvic Congestion Syndrome (PCS) affect a great number of women worldwide and often remain undiagnosed. Gynecological symptoms caused by vascular background demand a holistic approach for appropriate diagnosis. This is a relevant cause of chronic pelvic pain and atypical varicose veins. The diagnosis is based on imaging studies and their correlation with clinical presentation. Although the aetiology of PCS still remains unclear, it may result from a combination of factors including genetic predisposition, anatomical abnormalities, hormonal factors, damage to the vein wall, valve dysfunction, reverse blood flow, hypertension and dilatation. The following paper describes an in-depth overview of anatomy, pathophysiology, symptoms, diagnosis and treatment of PCS. In recent years, minimally invasive interventions have become the method of first choice for the treatment of this condition. The efficacy of a percutaneous approach is high and it is rarely associated with serious complications. Key Messages Pelvic venous disorders demand a holistic approach for appropriate diagnosis. This article takes an in-depth look at existing therapies of Pelvic Congestion Syndrome and pathophysiology of this condition. Embolisation is an effective and safe treatment option.

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Pelvic Congestion Syndrome

Cited by 14 publications

References 42 publications

Liquid and Solid Embolic Agents in Gonadal Veins

Liquid and Solid Embolic Agents in Gonadal Veins

Chronic pelvic pain in women

Comprehensive overview of the venous disorder known as pelvic congestion syndrome

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