Open AccessDoes pelvic venous congestion syndrome exist and can it be treated?
Author(s) -
BALL ELIZABETH,
KHAN KHALID S.,
MEADS CATHERINE
Publication year - 2012
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2012.01368.x
Subject(s) - medicine , venography , pelvic pain , asymptomatic , embolization , randomized controlled trial , radiology , psychological intervention , venous congestion , surgery , intensive care medicine , thrombosis , psychiatry
Chronic pelvic pain (CPP) is a common and costly health problem in gynecology. Operative pathological findings are often absent. In some women with CPP, pelvic venous congestion has been reported; however, this observation has also been made in asymptomatic women. Thus, it is not clear whether pelvic venous congestion causes CPP and, if it does, whether it is a direct or indirect cause. Venography and non‐invasive imaging methods are used for the diagnosis, but scoring systems have not been validated. The current mainstay of treatment is venography‐controlled embolization, which is less invasive than surgical interventions. However, the only evidence on effectiveness comes from uncontrolled case series. A systematic review of causation evidence is needed to prove whether pelvic venous congestion causes CPP and whether embolization treatment is effective. In addition, if causation is established, good‐quality primary randomized controlled trials on embolization may be required.