RSS-Feed abonnieren
DOI: 10.1055/s-0038-1636519
Pelvic Congestion Syndrome: Systematic Review of Treatment Success
Publikationsverlauf
Publikationsdatum:
05. April 2018 (online)
Abstract
Pelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the United States and up to 43.4% worldwide. In addition to individual physical, emotional, and quality-of-life implications of CPP, there are profound healthcare and socioeconomic expenses with estimated annual direct and indirect costs in the United States in excess of 39 billion dollars. PCS consists of clinical symptoms with concomitant anatomic and physiologic abnormalities originating in venous insufficiency. The etiology of PCS is diverse involving both mechanical and hormonal factors contributing to venous dilatation (>5 mm) and insufficiency. Factors affecting the diagnosis of PCS include variance of causes and clinical presentations of pelvic pain and relatively low sensitivity of noninvasive diagnostic imaging and laparoscopy to identify insufficiency compared with catheter venogram. A systematic review of the literature evaluating patient outcomes following percutaneous treatment of PCS is presented.
-
References
- 1 Ganeshan A, Upponi S, Hon LQ, Uthappa MC, Warakaulle DR, Uberoi R. Chronic pelvic pain due to pelvic congestion syndrome: the role of diagnostic and interventional radiology. Cardiovasc Intervent Radiol 2007; 30 (06) 1105-1111
- 2 Duncan CH, Taylor Jr HC. A psychosomatic study of pelvic congestion. Am J Obstet Gynecol 1952; 64 (01) 1-12
- 3 Taylor Jr HC. Vascular congestion and hyperemia; their effect on function and structure in the female reproductive organs; the clinical aspects of the congestion-fibrosis syndrome. Am J Obstet Gynecol 1949; 57 (04) 637-653
- 4 Taylor HC. Pelvic pain based on a vascular and autonomic nervous system disorder. Am J Obstet Gynecol 1954; 67 (06) 1177-1196
- 5 Beard RW, Reginald PW, Wadsworth J. Clinical features of women with chronic lower abdominal pain and pelvic congestion. Br J Obstet Gynaecol 1988; 95 (02) 153-161
- 6 Beard RW, Highman JH, Pearce S, Reginald PW. Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet 1984; 2 (8409): 946-949
- 7 Phillips D, Deipolyi AR, Hesketh RL, Midia M, Oklu R. Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management. J Vasc Interv Radiol 2014; 25 (05) 725-733
- 8 Beard RW, Kennedy RG, Gangar KF. , et al. Bilateral oophorectomy and hysterectomy in the treatment of intractable pelvic pain associated with pelvic congestion. Br J Obstet Gynaecol 1991; 98 (10) 988-992
- 9 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 (05) 931-939
- 10 Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol 1996; 87 (03) 321-327
- 11 Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health 2006; 6: 177-183
- 12 Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician 2014; 17 (02) E141-E147
- 13 Zondervan KT, Yudkin PL, Vessey MP. , et al. The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract 2001; 51 (468) 541-547
- 14 Kuligowska E, Deeds III L, Lu III K. Pelvic pain: overlooked and underdiagnosed gynecologic conditions. Radiographics 2005; 25 (01) 3-20
- 15 Klock S. Psychosomatic issues in obstetrics and gynecology. In: Ryan KJ, Barbieri RL. , eds. Gynecology Principles and Practice. St. Louis: Mosby; 1995: 399-402
- 16 Howard FM. The role of laparoscopy in chronic pelvic pain: promise and pitfalls. Obstet Gynecol Surv 1993; 48 (06) 357-387
- 17 Durham JD, Machan L. Pelvic congestion syndrome. Semin Intervent Radiol 2013; 30 (04) 372-380
- 18 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 (02) 448-458
- 19 Koo S, Fan CM. Pelvic congestion syndrome and pelvic varicosities. Tech Vasc Interv Radiol 2014; 17 (02) 90-95
- 20 Ignacio EA, Dua R, Sarin S. , et al. Pelvic congestion syndrome: diagnosis and treatment. Semin Intervent Radiol 2008; 25 (04) 361-368
- 21 Laborda A, Medrano J, de Blas I, Urtiaga I, Carnevale FC, de Gregorio MA. Endovascular treatment of pelvic congestion syndrome: visual analog scale (VAS) long-term follow-up clinical evaluation in 202 patients. Cardiovasc Intervent Radiol 2013; 36 (04) 1006-1014
- 22 Kim HS, Malhotra AD, Rowe PC, Lee JM, Venbrux AC. Embolotherapy for pelvic congestion syndrome: long-term results. J Vasc Interv Radiol 2006; 17 (2, Pt 1): 289-297
- 23 Dos Santos SJ, Holdstock JM, Harrison CC, Lopez AJ, Whiteley MS. Ovarian vein diameter cannot be used as an indicator of ovarian venous reflux. Eur J Vasc Endovasc Surg 2015; 49 (01) 90-94
- 24 Nascimento AB, Mitchell DG, Holland G. Ovarian veins: magnetic resonance imaging findings in an asymptomatic population. J Magn Reson Imaging 2002; 15 (05) 551-556
- 25 Rozenblit AM, Ricci ZJ, Tuvia J, Amis Jr ES. Incompetent and dilated ovarian veins: a common CT finding in asymptomatic parous women. AJR Am J Roentgenol 2001; 176 (01) 119-122
- 26 Latthe P, Mignini L, Gray R, Hills R, Khan K. Factors predisposing women to chronic pelvic pain: systematic review. BMJ 2006; 332 (7544): 749-755
- 27 Stones RW, Price C. Health services for women with chronic pelvic pain. J R Soc Med 2002; 95 (11) 531-535
- 28 Cheong YC, Smotra G, Williams AC. Non-surgical interventions for the management of chronic pelvic pain. Cochrane Database Syst Rev 2014; 3 (03) CD008797
- 29 Moher D, Liberati A, Tetzlaff J, Altman DG. ; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6 (07) e1000097
- 30 Meneses L, Fava M, Diaz P. , et al. Embolization of incompetent pelvic veins for the treatment of recurrent varicose veins in lower limbs and pelvic congestion syndrome. Cardiovasc Intervent Radiol 2013; 36 (01) 128-132
- 31 Capasso P, Simons C, Trotteur G, Dondelinger RF, Henroteaux D, Gaspard U. Treatment of symptomatic pelvic varices by ovarian vein embolization. Cardiovasc Intervent Radiol 1997; 20 (02) 107-111
- 32 Maleux G, Stockx L, Wilms G, Marchal G. Ovarian vein embolization for the treatment of pelvic congestion syndrome: long-term technical and clinical results. J Vasc Interv Radiol 2000; 11 (07) 859-864
- 33 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): 171-178
- 34 Pieri S, Agresti P, Morucci M, de' Medici L. Percutaneous treatment of pelvic congestion syndrome. Radiol Med (Torino) 2003; 105 (1-2): 76-82
- 35 Chung MH, Huh CY. Comparison of treatments for pelvic congestion syndrome. Tohoku J Exp Med 2003; 201 (03) 131-138
- 36 Kwon SH, Oh JH, Ko KR, Park HC, Huh JY. Transcatheter ovarian vein embolization using coils for the treatment of pelvic congestion syndrome. Cardiovasc Intervent Radiol 2007; 30 (04) 655-661
- 37 Creton D, Hennequin L, Kohler F, Allaert FA. Embolisation of symptomatic pelvic veins in women presenting with non-saphenous varicose veins of pelvic origin - three-year follow-up. Eur J Vasc Endovasc Surg 2007; 34 (01) 112-117
- 38 Asciutto G, Asciutto KC, Mumme A, Geier B. Pelvic venous incompetence: reflux patterns and treatment results. Eur J Vasc Endovasc Surg 2009; 38 (03) 381-386
- 39 Hocquelet A, Le Bras Y, Balian E. , et al. Evaluation of the efficacy of endovascular treatment of pelvic congestion syndrome. Diagn Interv Imaging 2014; 95 (03) 301-306
- 40 Neĭmark AI, Shelkovnikova NV. Endovascular treatment of persistent dysuria and chronic pelvic pain in women with pelvic varicose veins [in Russian]. Urologiia 2012; 4 (04) 20-24
- 41 Nasser F, Cavalcante RN, Affonso BB, Messina ML, Carnevale FC, de Gregorio MA. Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome. Int J Gynaecol Obstet 2014; 125 (01) 65-68
- 42 Grossman SA, Sheidler VR, McGuire DB, Geer C, Santor D, Piantadosi S. A comparison of the Hopkins Pain Rating Instrument with standard visual analogue and verbal descriptor scales in patients with cancer pain. J Pain Symptom Manage 1992; 7 (04) 196-203
- 43 Galkin EV, Grakova LS, Naumova EB. Roentgeno-endovascular surgery of hypofunctional ovaries in varicosities of the ovarian veins [in Russian]. Vestn Rentgenol Radiol 1991; 5 (05) 51-59
- 44 Bittles MA, Hoffer EK. Gonadal vein embolization: treatment of varicocele and pelvic congestion syndrome. Semin Intervent Radiol 2008; 25 (03) 261-270
- 45 Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2006; 86 (05) (Suppl. 01) S93-S95
- 46 Triebner K, Johannessen A, Puggini L. , et al. Menopause as a predictor of new-onset asthma: a longitudinal Northern European population study. J Allergy Clin Immunol 2015; 6749 (15) 1243-1249
- 47 Asciutto G, Mumme A, Marpe B, Köster O, Asciutto KC, Geier B. MR venography in the detection of pelvic venous congestion. Eur J Vasc Endovasc Surg 2008; 36 (04) 491-496
- 48 Yang DM, Kim HC, Nam DH, Jahng GH, Huh CY, Lim JW. Time-resolved MR angiography for detecting and grading ovarian venous reflux: comparison with conventional venography. Br J Radiol 2012; 85 (1014): e117-e122
- 49 Giacchetto C, Cotroneo GB, Marincolo F, Cammisuli F, Caruso G, Catizone F. Ovarian varicocele: ultrasonic and phlebographic evaluation. J Clin Ultrasound 1990; 18 (07) 551-555
- 50 Liddle AD, Davies AH. Pelvic congestion syndrome: chronic pelvic pain caused by ovarian and internal iliac varices. Phlebology 2007; 22 (03) 100-104
- 51 Park SJ, Lim JW, Ko YT. , et al. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. AJR Am J Roentgenol 2004; 182 (03) 683-688
- 52 Belenky A, Bartal G, Atar E, Cohen M, Bachar GN. Ovarian varices in healthy female kidney donors: incidence, morbidity, and clinical outcome. AJR Am J Roentgenol 2002; 179 (03) 625-627