Phlebolymphology N°90

Effectiveness of treatment for pelvic congestion syndrome

Ralph L. M. KURSTJENS1; Mark WHITELEY2; Cees H. A. WITTENS1,3 1 Department of Vascular Surgery, Maastricht University Medical Centre+, Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands Department of Obstetrics and Gynaecology, Haga Teaching Hospital, The Hague, The Netherlands. 2 The Whiteley Clinic and Faculty of Health and Biomedical Sciences, University of Surrey. Guildford, UK 3 Department of Vascular Surgery, University Hospital Aachen, Aachen, Germany Abstract Pelvic congestion syndrome accounts for approximately 16% to 31% of patients suffering from chronic pelvic pain, and it is the second most frequent cause of pelvic pain after endometriosis. It is a poorly understood disease,…

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Clinical aspects of pelvic congestion syndrome

Pier Luigi ANTIGNANI1; George GEROULAKOS2; Mamuka BOKUCHAVA3 1 Director, Vascular Center, Nuova Villa Claudia, Rome, Italy 2 Consultant Vascular Surgeon, Department of Surgery, Charing Cross Hospital, London, UK 3 Deputy Director of the Center of Vascular and Heart Diseases, Tbilisi, Georgia Abstract The main symptom of pelvic congestion syndrome (PCS) is pelvic pain. Women typically have a dull, throbbing, and achy pain in the vulvar region, which often worsens during or after intercourse, just before the onset of menstruation, and as the day progresses, especially in women who stand or sit for long periods. The cause of PCS is unknown;…

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Instrumental diagnosis of pelvic congestion syndrome

Santiago ZUBICOA EZPELETA1; Javier LEAL MONEDERO1; Assila T. ELKASHISHI2 1 Ruber Internacional Hospital, Angiology and Vascular Surgery Unit, Madrid, Spain 2 Al Salam Hospital, Cairo, Egypt Abstract Pelvic congestion syndrome (PCS) is a multifactorial medical condition that is characterized by the absence of specific symptoms, and therefore, it needs very precise imaging for an accurate diagnosis. Diagnostic techniques can be noninvasive (duplex ultrasound) or minimally invasive (magnetic resonance, CT, and phlebography). Duplex ultrasound is regarded as a first-line investigation for PCS because it is noninvasive, easily accessible, and inexpensive. This procedure provides essential hemodynamic information, and when combining transvaginal and…

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Treatment options for pelvic congestion syndrome

Javier LEAL MONEDERO1; Santiago ZUBICOA EZPELETA1; Neil M. KHILNAN2 1 Ruber Internacional Hospital, Angiology and Vascular Surgery Unit, Madrid, Spain 2 Division of Interventional Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA Abstract Pelvic congestion syndrome (PCS) and its main symptom, chronic pelvic pain, are caused by an increase in pressure, number, and caliber of intrapelvic venous structures. These structures are veins with a varicose morphology (ie, tortuous and ectatic with a very retarded flow) that are typically caused by inverted flow in the valveless and enlarged gonadal axis and, in some cases, the branches…

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Pelvic congestion syndrome: does one name fit all?

Sergio GIANESINI1; Pier Luigi ANTIGNANI2; Lorenzo TESSARI1 1 Glauco Bassi Foundation, Trieste, Italy 2 Director, Vascular center, Nuova Villa Claudia, Rome, Italy Abstract The pelvic congestion syndrome definition includes two not so frequently overlapping scenarios: (i) pelvic venous engorgement with lower abdomen symptomatology; and (ii) lower limb varicose veins fed by pelvic escape points that are generally less prone to develop the abdominal clinical manifestation typical for pelvic congestion syndrome. We retrospectively evaluated 985 female patients (43±11 years old; 23±5kg/m2 BMI) who visited our offices for lower limb varicose veins of pelvic origin. Second-level imaging was needed for 229 patients….

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Pelvic congestion syndrome: prevalence and quality of life

Zaza LAZARASHVILI1; Pier Luigi ANTIGNANI2; Javier LEAL MONEDERO3 1 Chapidze Emergency Cardiovascular Center, Liubljana str.4, 0159 Tbilisi, Georgia 2 Director, Vascular center, Nuova Villa Claudia, Rome, Italy 3 Ruber International Hospital, Angiology and Vascular Surgery Unit, La Masó St. 38, 28034, Madrid, Spain Abstract Pelvic congestion syndrome is an important cause of chronic pelvic pain that develops due to pelvic, but particularly ovarian, vein incompetence. Pelvic pain is one of the frequent reasons for outpatient gynecologic visits. Unfortunately, large and reliable studies on the prevalence of pelvic congestion syndrome do not yet exist; therefore, only indirect data, such as the…

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Medical treatment of pelvic congestion syndrome

Omur TASKIN1; Levent SAHIN2; Sergey G. GAVRILOV3; Zaza LAZARASHVILI4 1 Akdeniz School of Medicine, Department of Obstetrics and Gynaecology, Antalya, Turkey 2 Kafkas School of Medicine, Departme of Obstetrics and Gynaecology, Kars, Turkey 3 Leninskii Prospekt, Moscow, Russia 4 Chapidze Emergency Cardiovascular Center, Tbilisi, Georgia Abstract Pelvic congestion syndrome (PCS) has no clear etiology and the diagnosis relies on precise investigation techniques. PCS patients present with chronic symptoms in the area of the pelvis, which may have various etiologies; therefore, before any treatment is administered, it is important to exclude other medical conditions that may cause similar symptoms. Treatment options…

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Phlebolymphology N°90 – Editorial

Dear Readers, It is estimated that one third of all women will experience chronic pelvic pain in their lifetime. Recent advances show the pain may be due to pelvic congestion syndrome, which is caused by hard-to-detect varicose veins in the pelvis. According to the VEIN-TERM Transatlantic Interdisciplinary Consensus Document, pelvic congestion syndrome is defined as: “chronic symptoms which may include pelvic pain, perineal heaviness, urgency of micturition and post-coital pain, caused by ovarian and/or pelvic vein reflux and/or obstruction, and which may be associated with vulvar, perineal, and/or lower extremity varices”. The aim of the current issue, specially dedicated to…

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Phlebolymphology N°90 (Vol 23 – N°3 – 2016)

EDITORIAL Editorial By Pier Luigi ANTIGNANI (Rome, Italy), Javier Leal MONEDERO (Madrid, Spain), Santiago Zubicoa EZPELETA (Madrid, Spain), Zaza LAZARASHVILI (Tbilisi, Georgia) Phlebolymphology – 2016 ; 23 (3): 122 PHLEBOLOGY Pelvic congestion syndrome: prevalence and quality of life Zaza LAZARASHVILI (Tbilisi, Georgia) Phlebolymphology – 2016 ; 23 (3): 123 Clinical aspects of pelvic congestion syndrome Pier Luigi ANTIGNANI (Rome, Italy) Phlebolymphology – 2016 ; 23 (3): 127 Instrumental diagnosis of pelvic congestion syndrome Santiago ZUBICOA EZPELETA (Madrid, Spain) Phlebolymphology – 2016 ; 23 (3): 130 Treatment options for pelvic congestion syndrome Javier LEAL MONEDERO (Madrid, Spain) Phlebolymphology – 2016 ;…

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