title: Pelvic congestion syndrome: the current state of the literature.
abstract: OBJECTIVE
  Pelvic congestion syndrome is an uncommon poorly understood and frequently misdiagnosed disorder of the pelvic venous circulation, which causes chronic pelvic pain in women in premenopausal age. This condition has typical features, such as pelvic varicosities, pelvic pain worsened by prolonged standing, coitus, menstruation, and pregnancy.
  
  
  METHODS
  The precise etiology of this syndrome remains uncertain, and it is probably multifactorial. Valvular insufficiency, venous obstruction, and hormones all may play a role in the development of congestion of the pelvic veins.
  
  
  RESULTS
  Pelvic pain and venous varices are often both present in premenopausal women, but not necessarily causally related. Furthermore, incompetent and dilated pelvic veins are a common finding in asymptomatic women. As such, it is challenging but important to determine which patients have chronic pelvic pain specifically related to pelvic congestion syndrome in order to treat them properly.
  
  
  CONCLUSIONS
  Once the syndrome has been accurately diagnosed, medical, surgical, or minimally invasive endovascular treatments can improve symptoms in a high percentage of cases. This updated nonsystematic review of the literature explores the pathophysiology, clinical features, diagnostic investigations, and treatment option of this complex condition that affects young women with considerable implications for their daily social and psychological condition.
authors.affiliation: Department of Obstetrics and Gynecology, S. Anna University Hospital, Ferrara, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Borghi
authors.affiliation: Department of Urology, S. Anna University Hospital, 8 A. Moro Street, 44124, Cona, FE, Italy. dellatti@hotmail.com.
authors.forename: Lucio
authors.initials: L
authors.lastname: Dell'Atti
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy; D003952:Diagnostic Imaging / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010388:Pelvis / Q000098:blood supply; D013577:Syndrome; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D014680:Veins
keywords: Chronic pelvic pain; Pelvic congestion; Pelvic varices; Pelvic venous insufficiency; Sclero-embolization