What is pelvic congestion?

Objectives:

We prospectively evaluated transabdominal and transvaginal sonographic findings of patients with pelvic congestion syndrome and compared them with those of healthy volunteers.

Subjects and

Methods:

We examined 32 patients with pelvic congestion syndrome and 35 control subjects. Using transabdominal sonography, we evaluated the ovarian veins for diameter and flow direction, presence of pelvic varicocele, diameter of the pelvic veins, change of the duplex waveform during the Valsalva's maneuver, volume of the uterus, and presence of polycystic changes in the ovaries. We compared and statistically analyzed each parameter in the pelvic congestion syndrome group and in the control group.

Results:

The mean (+/- SD) diameter of the left ovarian vein was 0.79 +/- 0.23 cm in the pelvic congestion syndrome group and 0.49 +/- 0.15 cm in the control group (p = 0.000). Reversed caudal flow in the left ovarian vein was present in 22 of 22 patients and in four of 16 control subjects. Pelvic varicoceles were present in all patients with pelvic congestion syndrome and in six control subjects. The mean diameter of the left pelvic vein was 0.68 +/- 0.21 cm in the pelvic congestion syndrome group and 0.42 +/- 0.19 cm in the control group; the mean diameter of the right pelvic vein was 0.64 +/- 0.24 cm in the pelvic congestion syndrome group and 0.35 +/- 0.14 cm in the control group (p = 0.000). Polycystic changes of the ovary were present in 13 patients with pelvic congestion syndrome (40.6%) and four control subjects (11.4%).

Conclusion:

Sonographic findings of pelvic congestion syndrome were dilated left ovarian vein with reversed caudal flow, presence of varicocele, dilated arcuate veins crossing the uterine myometrium, polycystic changes of the ovary, and variable duplex waveform during the Valsalva's maneuver. Combined transabdominal and transvaginal sonography are potentially useful as a noninvasive screening tool for determining which patients with chronic pelvic pain may benefit from selective ovarian venography and transcatheter embolization.

Please click on the required question.

•  Pelvic Pain. Is this a common problem?
•  What are the common causes of pelvic pain in women?
•  What are the more common gynaecological causes of pelvic pain?
•  What are the more common non-gynaecological causes of pelvic pain?
•  What are primary and secondary dysmenorrhoea - painful periods?
•  What is retrograde menstruation?
•  How can dysmenorrhoea - painful periods be treated?
•  What are ovarian cysts?
•  How do ovarian cysts cause pain?
•  How are ovarian cysts diagnosed?
•  How are ovarian cysts treated?
•  I think I may be pregnant and I have some pelvic pain. What should I do?
•  What is pelvic inflammatory disease and how can it be treated?
• Mittelschmertz

FIBROIDS

• 14 What are fibroids?
• 15 I have fibroids. What difficulties might they cause for me?
• 16 How are fibroids diagnosed?
• 17 How could my fibroids be treated?

ENDOMETRIOSIS

• 18 What is endometriosis?
• 19 How prevalent is endometriosis?
• 20 What causes endometriosis?
• 21 How can my endometriosis be treated?
• 22 How can my doctor determine the cause of my pelvic pain?
• 23 What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
• 24 What is laparoscopy?
• 25 What are pelvic adhesions?
• 26 I have chronic pelvic pain. Could this be related to adhesions?
• 27  What is uterine retroversion (retroverted uterus)
• 28  Does a retroverted uterus (backward tilted uterus) cause symptoms?
• 29 How is a retroverted uterus - backward tilted uterus - treated?
• 30 What is pelvic congestion?
• 31 What causes pain associated with sexual intercourse (dyspareunia)
• 32 How can painful sexual intercourse (dyspareunia) be treated?
• 33 What is a pelvic mass?

IRRITABLE BOWEL SYNDROME - IBS

• 34 What is irritable bowel syndrome?
• 35 How can we find out if I have irritable bowel syndrome?
• 36 Is irritable bowel syndrome (IBS) a common condition?
• 37 What causes IBS?
• 38 What is the pain associated with IBS like?
• 39 Can IBS be mistaken for gynaecological problems?
• 40 How can my IBS be treated?
• 41 What other treatments are available for IBS?
• 42 What can be done to reduce the amount of bowel gas(flatus)
• 43 What is constipation?
• 44 What causes constipation?
• 45  How can constipation be treated?
• 46 How could we summarise the treatments that are available for my pelvic pain?
• 47 Where can I obtain more information?
• 48 Pelvic Pain Support Groups.
• 49 Endometriosis Support Groups.
• 50 IBS Support Groups.

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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.