DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20220929
Published: 2022-03-25

Pelvic congestion syndrome: a potentially treatable cause of intractable dysmenorrhoea

Nivedita Jha, Dasari Papa, Haritha Sagili, Nagarajan Krishnan

Abstract


Pelvic congestion syndrome (PCS) comprises a constellation of symptoms such as noncyclical pelvic pain, pelvic varicosities, dysmenorrhea and dyspareunia in multiparous women of reproductive age. It occurs due to pelvic venous insufficiency. The condition is a challenging entity and diagnosed after excluding other pelvic pathologies. Although venography has been considered gold standard for imaging diagnosis, Doppler ultrasonography, cross sectional imaging of pelvic veins at CT and MRI have been shown to provide adequate and accurate diagnosis. Here we report a case of intractable dysmenorrhoea in a 42-year multiparous woman and its successful management with embolization of pelvic varicose veins.

 


Keywords


Chronic pelvic pain, Pelvic venous insufficiency, PCS, Intractable dysmenorrhoea, Gonadal vein embolization

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References


Desimpelaere JH, Seynaeve PC, Hagers YM, Appel BJ, Mortelmans LL. Pelvic congestion syndrome: demonstration and diagnosis by helical CT. Abdom Imaging. 1999;24:100-2.

Kuligowska E, Deeds L, Lu K. Pelvic pain: overlooked and underdiagnosed gynecologic conditions. Radio Graphics. 2005;25:3-20.

Beard RW, Reginald PW, Wadsworth J. Clinical features of women with chronic lower abdominal pain and pelvic congestion. Br J Obstet Gynaecol. 1988;95:153-61.

Beard RW, Highman JH, Pearce S, Reginald PW. Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet. 1984;2:946-9.

Nicholson T, Basile A. Pelvic congestion syndrome: who should we treat and how? Tech Vasc Interv Radiol. 2006;9:19-23.

Soysal ME, Soysal S, Vicdan K, Ozer S. A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. Hum Reprod. 2001;16:93-9.

Ignacio EA, Dua R, Sarin S. Pelvic congestion syndrome: diagnosis and treatment. Semin Intervent Radiol. 2008;25:361-8.

Greiner M. Syndrome de congestion pelvienne: diagnostic et traitement. Phlébologie. 2005;58:293-8.

Knuttinen MG, Xie K, Jani A, Palumbo A, Carrillo T, Mar W. Pelvic venous insufficiency: imaging diagnosis, treatment approaches, and therapeutic issues. AJR Am J Roentgenol. 2015;204(2):448-58.

Karaosmanoğlu D, Karcaaltincaba M, Akata D, Ozmen M. Unusual causes of left renal vein compression along its course: MDCT findings in patients with nutcracker and pelvic congestion syndrome. Surg Radiol Anat. 2010;32(4):323-7.