Microvascular changes in the peripheral microcirculation of women with chronic pelvic pain due to congestion.
OBJECTIVE
Pelvic venous congestion is a common finding in women with chronic pelvic pain. While the pathophysiology of this condition is poorly understood, there are clear indications that it involves vascular dysfunction. The present studies sought abnormalities in microvascular function in these patients.


METHODS
Prospective longitudinal study.


METHODS
A teaching hospital tertiary referral.


METHODS
Eighteen women with pelvic congestion and 13 normal women.


METHODS
Parameters of microcirculatory function were measured in the calves of women using venous congestion plethysmography during the midfollicular and midluteal phases of the menstrual cycle. The women with pelvic congestion were studied again after treatment for the condition.


METHODS
Isovolumetric venous pressure, microvascular filtration capacity and limb blood flow.


RESULTS
Of the measured parameters of microvascular function, only isovolumetric venous pressure (Pvi) was significantly higher in women with congestion when compared to the controls during the same phase of the cycle. There were no menstrual cycle related differences in any of the other measured parameters in either patients or controls. Following successful treatment for the condition, values of Pvi in women with pelvic congestion were significantly reduced, achieving a level similar to that observed in the controls.


CONCLUSIONS
The observed changes in Pvi suggest that this parameter is intimately associated with the pathophysiology of pelvic congestion. The increase in Pvi, without alterations in other measured microvascular parameters, may be attributable to systemic increases in postcapillary resistance secondary to neutrophil activation. These findings support the notion of systemic microvascular dysfunction in these women.
Foong
L C
LC
Department of Obstetrics and Gynaecology, St Mary's Hospital Medical School, London, UK.
Gamble
J
J
Sutherland
I A
IA
Beard
R W
RW
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002908:Chronic Disease; D005121:Extremities / Q000098:blood supply; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D017699:Pelvic Pain / Q000503:physiopathology*; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*; D011446:Prospective Studies