Pelvic congestion syndrome is a condition that results from congestion of the pelvic veins. It is one of commonly missed and potentially treatable cause of chronic abdominal or pelvic pain.
It tends to prevail in multiparous, pre-menopausal women who typically present with chronic pelvic pain for more than 6 months 1. The overall population prevalence may approach ~10%.
It is considered the female equivalent to a testicular varicocele.
It is caused by:
- venous obstruction such as retro aortic left renal vein
- compression of left renal vein by SMA also known as nutcracker phenomenon, or right iliac vein compression
- incompetent valves in ovarian vein
The diagnosis of pelvic congestion syndrome is established by the demonstration of multiple dilated, tortuous parauterine veins with a width greater than 4 mm or an ovarian vein diameter greater than 8 mm 4.
May show multiple dilated veins in the adnexae with venous colour flow on colour Doppler.
Contrast enhanced CT typically shows dilated pelvic and ovarian veins.
Treatment options include coil embolisation of the gonadal vein: ovarian vein embolisation.
- 1. Park SJ, Lim JW, Ko YT et-al. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. AJR Am J Roentgenol. 2004;182 (3): 683-8. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Umeoka S, Koyama T, Togashi K et-al. Vascular dilatation in the pelvis: identification with CT and MR imaging. Radiographics. 24 (1): 193-208. doi:10.1148/rg.241035061 - Pubmed citation
- 3. Venbrux AC, Chang AH, Kim HS et-al. Pelvic congestion syndrome (pelvic venous incompetence): impact of ovarian and internal iliac vein embolotherapy on menstrual cycle and chronic pelvic pain. J Vasc Interv Radiol. 2002;13 (2 Pt 1): 171-8. - Pubmed citation
- 4. Haaga JR, Boll D. CT and MRI of the whole body. Mosby. (2009) ISBN:0323053750. Read it at Google Books - Find it at Amazon
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Pelvic Congestion Syndrome||✗|
|Pelvic venous incompetence||✗|