title: Does pelvic venous congestion syndrome exist and can it be treated?
abstract: Chronic pelvic pain (CPP) is a common and costly health problem in gynecology. Operative pathological findings are often absent. In some women with CPP, pelvic venous congestion has been reported; however, this observation has also been made in asymptomatic women. Thus, it is not clear whether pelvic venous congestion causes CPP and, if it does, whether it is a direct or indirect cause. Venography and non-invasive imaging methods are used for the diagnosis, but scoring systems have not been validated. The current mainstay of treatment is venography-controlled embolization, which is less invasive than surgical interventions. However, the only evidence on effectiveness comes from uncontrolled case series. A systematic review of causation evidence is needed to prove whether pelvic venous congestion causes CPP and whether embolization treatment is effective. In addition, if causation is established, good-quality primary randomized controlled trials on embolization may be required.
authors.affiliation: Department of Obstetrics and Gynaecology, Royal London Hospital, London Centre for Primary Care and Public Health, Queen Mary University of London, London, UK. elizabeth.ball@bartsandthelondon.nhs.uk
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ball
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Khan
authors.forename: Catherine
authors.initials: C
authors.lastname: Meads
mesh_terms: D002908:Chronic Disease; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000150:complications* / Q000628:therapy; D017699:Pelvic Pain / Q000209:etiology*; D010388:Pelvis / Q000098:blood supply*; D013577:Syndrome