Pelvic congestion syndrome: diagnosis and treatment

Elizabeth A Ignacio, Ruchika Dua, Shawn Sarin, Amy Soltes Harper, Douglas Yim, Vivek Mathur, Anthony C Venbrux, Elizabeth A Ignacio, Ruchika Dua, Shawn Sarin, Amy Soltes Harper, Douglas Yim, Vivek Mathur, Anthony C Venbrux

Abstract

The diagnosis of pelvic congestion syndrome (PCS) continues to challenge all physicians involved especially those in such specialties as anesthesia, gastroenterology, general surgery, obstetrics and gynecology, and interventional radiology. When other pelvic pathology is ruled out, an interventional radiologist may be consulted for additional evaluation and treatment of PCS. A heightened awareness and clinical suspicion for the specific symptomatology and associated findings may bring about a more rapid progression toward treatment. For most interventional radiologists who treat PCS patients, magnetic resonance imaging/MR venography (MRI/MRV), diagnostic venogram, and embolotherapy are at the center of diagnosis and treatment of PCS.

Keywords: Chronic pelvic pain; congestion syndrome; embolization; ovarian vein embolotherapy; pelvic; pelvic varices.

Figures

Figure 1
Figure 1
Vulvar varices under soft tissue; note asymmetry.
Figure 2
Figure 2
Varices extending into leg.
Figure 3
Figure 3
Vulvar varices venogram.
Figure 4
Figure 4
Vulvar varices post embolization.
Figure 5
Figure 5
Right ovarian venogram.
Figure 6
Figure 6
Right ovarian varices.
Figure 7
Figure 7
Post coil embolization. No variceal filling.
Figure 8
Figure 8
Left internal iliac venogram; pelvic varices with filling to the right side.
Figure 9
Figure 9
Post embolization with sodium morrhuate; no variceal filling.

Source: PubMed

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