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Endometriosis: Clinical Manifestation and Differential Diagnosis
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Pelvic Congestion Syndrome is frustratingly a difficult diagnosis due to controversial diagnostic methods and poor understanding of its etiology, and there are no specific diagnostic criteria. The symptoms of this condition can greatly overlap with many pelvic conditions, and the syndrome can be seen more in multiparous and overweight women, as well as present secondary to vascular anomalies and previous pelvic thrombotic events (55). Attention to the presence of varicosities and hemorrhoids can be a clue as well as worsening of premenstrual symptoms, after long standing, fatigue and after intercourse. Ultrasound assessment will show the diameter of the uterine vessels more than 8 mm, and Doppler studies will observe slow blood flow, reversed direction and the communicating pattern of the arcuate veins (64).
Non-Gynecological Causes of Pelvic Pain
Published in Juan Luis Alcázar, María Ángela Pascual, Stefano Guerriero, Ultrasound of Pelvic Pain in the Non-Pregnant Female, 2019
Pelvic congestion syndrome is a clinical entity that may cause chronic pelvic pain. It is characterized by the presence of varicose veins in the pelvis, mostly involving the uterine venous plexus. The main cause of pelvic congestion syndrome is incompetence of ovarian and uterine veins.
Venous compression syndromes
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
Left renal vein congestion can cause left flank or lower quadrant pain occasionally radiating to the outer thigh and buttock, exacerbated by standing or walking. Ovarian vein congestion can cause pelvic congestion syndrome.
Comprehensive overview of the venous disorder known as pelvic congestion syndrome
Published in Annals of Medicine, 2022
Kamil Bałabuszek, Michał Toborek, Radosław Pietura
Pelvic Venous Disorders manifests in many clinical presentations. Pelvic Congestion Syndrome is a common condition occurring worldwide, in which a significant proportion of cases remain undiagnosed and symptoms reported by women are often underestimated, due to poor knowledge of the condition. It is an important cause of chronic pelvic pain in female patients. It can also present with superficial varicose veins as the only symptom as well as in combination with pain. Symptoms can be non-specific and difficult to distinguish from other diseases. Certain diagnosis of the PCS is very challenging, due to its multiformity. Determining which patients suffer from symptoms associated with PCS is hard, but also extremely important to implement appropriate and targeted treatment. Future randomised trials on embolisation management are needed. A common treatment algorithm for trials based on an understanding of the mechanisms leading to symptoms would be particularly helpful in objectively evaluating outcomes.
The Vici venous stent for treatment of renal vein entrapment
Published in Baylor University Medical Center Proceedings, 2021
Alex T. Cubberley, Mohanad Hamandi, Courtney Rawitscher, Karim Al-Azizi, Sameh Sayfo, Srinivasa Potluri, Phillip A. Morales, Javier Vasquez, Chadi Dib
The nutcracker syndrome (NCS) is an uncommon vascular anomaly that results from compression of the left renal vein between the superior mesenteric artery and the aorta.1 Patients with NCS usually present with pelvic pain, flank pain, hematuria, gonadal varices, or proteinuria.2,3 Some studies have reported pelvic congestion syndrome and ovarian vein reflux in up to 30% of women who are completely asymptomatic.3 The diagnosis and treatment of NCS is important, as it is associated with an increased risk of chronic kidney disease from long-term left renal vein hypertension, proteinuria, and left renal vein thrombosis.2 Management varies depending on the severity of symptoms, from conservative therapy to endovascular or open surgery.3 We present a 37-year-old woman with severe debilitating left flank and abdominal pain due to NCS. To our knowledge, this is the first reported case of symptomatic left renal vein compression treated with the new Vici stent system.
Surgical aspects of venous pelvic pain treatment
Published in Current Medical Research and Opinion, 2019
S. G. Gavrilov, O. I. Efremova
Pelvic congestion syndrome (PCS) is a pathological state that is caused by varicose transformation of pelvic veins and is characterized by occurrence of chronic pelvic pain (CPP), coital and post-coital pain, dysmenorrhea and dysuric disorders1,2. In patients with CPP, the PCS-related pain syndrome is observed in about 15% of women of reproductive age and 30% of women consulting a gynecologist for pelvic pain3. Pelvic pain in PCS has specific features: namely, it is more often localized in the left or right iliac region; is constant, dull and aching in nature; more severe in the second half of the menstrual cycle, during static or physical loads, or due to the use of hormonal agents containing gestagene; and is relieved by resting in a supine position or treatment with venoactive drugs. In this regard, the Russian clinical guidelines for the diagnosis and treatment of chronic venous diseases (2018) advise using the term “venous pelvic pain” (VPP), which describes non-cyclic pain lasting for more than 6 months and occurring due to dilation of intrapelvic veins, which is localized in the pelvic region, affects patient’s quality of life, and requires medical or surgical treatment4. VPP relief is a main goal of therapeutic measures in PCS.