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Pelvic congestion syndrome as a cause of chronic pelvic pain

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.236

Abstract

Altered pelvic venous circulation, which may occur due to pelvic venous congestion and varicose veins of the vulva, may be among the causes for developing chronic pelvic pain syndrome. Pelvic congestion syndrome (PCS) is characterized by chronic discomfort in the pelvic area, which may be aggravated during coitus or acquire orthostatic position, and result in severe dysfunction of the pelvic organs. Varicose veins of the vulva develop due to obstruction of the veins, increased venous pressure, and venous insufficiency in the pelvis. Varicose veins may be isolated or associated with varicose veins of the lower extremities. The diagnosis and treatment of such patients are limited by the lack of definitive clinical criteria for early diagnostics, which were discussed in the current study.

About the Authors

N. Yu. Novikova
Mechnikov North-Western State Medical University, Health Ministry of Russian Federation
Russian Federation

Natalia Yu. Novikova - 4th year Student, Mechnikov North-Western State Medical University.

47 Piskarevskiy Prospect, Saint Petersburg 195067.



V. I. Tsibizova
Almazov National Medical Research Centre, Health Ministry of Russian Federation
Russian Federation

Valentina I. Tsibizova - MD, PhD, Obstetrician-Gynecologist, Research Laboratory of Operative Gynecology, Institute of Perinatology and Pediatrics; Physician, Department of Functional and Ultrasound Diagnostics, Almazov National Medical Research Centre.

2 Akkuratova Str., Saint Petersburg 197341.



P. D. Puzdriak
Saint Petersburg City Multidisciplinary Hospital № 2
Russian Federation

Petr D. Puzdriak - MD, Cardiovascular Surgeon, Saint Petersburg City Multidisciplinary Hospital № 2; Council Member of RPO «Doctors of Saint Petersburg».

5 Uchebniy Рereulok, Saint Petersburg 194354.

Scopus Author ID: 57194489779.

Researcher ID: K-9787-2016.

Author ID: 972690.

SPIN-код: 3061-2307.



E. V. Komlichenko
Almazov National Medical Research Centre, Health Ministry of Russian Federation
Russian Federation

Eduard V. Komlichenko - MD, Dr Sci Med, Deputy Director, Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre.

2 Akkuratova Str., Saint Petersburg 197341.

Scopus Author ID: 56357908200.

Researcher ID: N-5315-2015.



I. G. Tsnobiladze
Almazov National Medical Research Centre, Health Ministry of Russian Federation
Russian Federation

Ia G. Tsnobiladze - MD, Obstetrician-Gynecologist, Almazov National Medical Research Centre.

2 Akkuratova Str., Saint Petersburg 197341.



A. V. Malushko
Almazov National Medical Research Centre, Health Ministry of Russian Federation
Russian Federation

Anton V. Malushko - MD, Obstetrician-Gynecologist, Almazov National Medical Research Centre.

2 Akkuratova Str., Saint Petersburg 197341.



M. A. Ivanov
Mechnikov North-Western State Medical University, Health Ministry of Russian Federation
Russian Federation

Mikhail A. Ivanov - MD, Dr Sci Med, Professor, Department of General Surgery, Mechnikov North-Western State Medical University.

47 Piskarevskiy Prospect, Saint Petersburg 195067.

Author ID: 633714.

SPIN-код: 9368-6652.



K. A. Chizhova
Mechnikov North-Western State Medical University, Health Ministry of Russian Federation
Russian Federation

Ksenia A. Chizhova - 5th year Student, Mechnikov North-Western State Medical University.

47 Piskarevskiy Prospect, Saint Petersburg 195067.



P. B. Bondarenko
Saint Petersburg City Multidisciplinary Hospital № 2
Russian Federation

Pavel B. Bondarenko - MD, Cardiovascular Surgeon, Department of Vascular Surgery.

5 Uchebniy Рereulok, Saint Petersburg 194354.



I. M. Kositsyna
Saint Petersburg City Multidisciplinary Hospital № 2
Russian Federation

Inga M. Kositsyna - MD, Radiologist, Saint Petersburg City Multidisciplinary Hospital № 2.

5 Uchebniy Рereulok, Saint Petersburg 194354.



D. V. Blinov
Institute for Preventive and Social Medicine; Lapino Clinical Hospital, GC «Mother and Child»
Russian Federation

Dmitry V. Blinov - MD, PhD, MBA, Head of Medical and Scientific Affairs, Institute for Preventive and Social Medicine; Neurologist, Lapino Clinical Hospital, MD Medical Group.

4–10 Sadovaya-Triumfalnaya Str., Moscow 127006; 111, 1st Uspenskoe Highway, Lapino, Odintsovo District, Moscow region 143081.

Scopus Author ID: 6701744871.

Researcher ID: E-8906-2017. RSCI: 9779-8290.



References

1. Wozniak S. Chronic pelvic pain. Ann Agric Environ Med. 2016;23(2):223-6. https://doi.org/10.5604/12321966.1203880.

2. Zaitsev A.V., Sharov M.N., Kan Ya.D. et al. Chronic pelvic pain. The modern-day multimodal idea of the problem. Promises for diagnosis and treatment. [Hronicheskaya tazovaya bol'. Sovremennoe mul'timodal'noe predstavlenie o probleme. Perspektivy diagnostiki i lecheniya]. Rossijskij zhurnal boli. 2015;(2):3-8. (In Russ.).

3. de Almeida G.R., Silvinato A., Simoes R.S. et al. Pelvic congestion syndrome - treatment with pelvic varicose veins embolization. Rev Assoc Med Bras (1992). 2019;65(4):518-23. https://doi.org/10.1590/1806-9282.65.4.518.

4. Santoshi R.K.N., Lakhanpal S., Satwah V. et al. Iliac vein stenosis is an underdiagnosed cause of pelvic venous insufficiency. J Vasc Surg Venous Lymphat Disord. 2018;6(2):202-11. https://doi.org/10.1016/j.jvsv.2017.09.007.

5. Fomina E.E., Akhmetzyanov R.V., Tukhbatullin M.G. Methodology of ultrasound investigation of pelvic varicose disease. [Metodologiya ul'trazvukovogo issledovaniya pri varikoznoj bolezni ven taza]. Prakticheskaya medicina. 2016;(9):53-8. (In Russ.).

6. Kurbonova N.N., Sultanov D.D., Yatimova R.M. Varicose disease of the minor pelvis - the problem of the gynecology and vascular surgery. [Varikoznaya bolezn' ven malogo taza - problema na styke ginekologii i sosudistoj hirurgii]. Zdravoohranenie Tadzhikistana. 2018;(2):68-75. (In Russ.).

7. Grigoryev E.G., Lebedeva D.V., Grigoryev S.E. Chronic pelvic pain in women. [Hronicheskaya tazovaya bol' u zhenshchin]. Byulleten' sibirskoj mediciny. 2020;19(3):120-7. (In Russ.). https://doi.org/10.20538/1682-0363-2020-3-120-127.

8. Dobrokhotova Yu.E., Ikhtiyarova G.A., Dustova N.K. et al. Features of a current pregnancy and delivery in pregnant women with varicose. [Osobennosti techenie beremennosti i rodov u beremennyh s varikoznoj bolezn'yu]. Evrazijskij vestnik pediatrii. 2020;2(5):77-84. (In English). https://cutt.ly/SveCyXB.

9. Nosenko N.S., Nosenko E.M., Khramchenko N.V. Specific changes in the venous system of lower extremities in pregnant women (literature review). [Osobennosti izmenenij venoznoj sistemy nizhnih konechnostej u beremennyh (obzor)]. Kremlevskaya medicina. Klinicheskij vestnik. 2017;(1):128-34. (In Russ.).

10. Minullina N.K., Akhmetova D.I. Modern understanding of pelvic varicose vein disease in the structure of chronic pelvic pain syndrome: diagnosis and treatment (review). [Sovremennye predstavleniya o varikoznoj bolezni ven taza v strukture sindroma hronicheskih tazovyh bolej: diagnostika i lechenie (obzor)]. Vestnik sovremennoj klinicheskoj mediciny. 2020;13(2):62-9. (In Russ.). https://doi.org/10.20969/VSKM.2020.13(2).62-69.

11. Marcelin C., Izaaryene J., Castelli M. et al. Embolization of ovarian vein for pelvic congestion syndrome with ethylene vinyl alcohol copolymer (Onyx®). Diagn Interv Imaging. 2017;98(12):843-8. https://doi.org/10.1016/j.diii.2017.05.011.

12. Akhmetzianov R.V., Bredikhin R.A., Fomina E.E., Konovalova E.F. Morphological parallels of the structure of vessel's wall at varicose extension of the veins of pelvis and lower extremities. [Morfologicheskie paralleli stroeniya sosudistoj stenki pri varikoznom rasshirenii ven taza i nizhnih konechnostej]. Morfologicheskie vedomosti. 2020;28(2):24-31. (In Russ.). https://doi.org/10.20340/mv-mn.2020.28(2):24-31.

13. Jurga-Karwacka A., Karwacki G.M., Schoetzau A. et al. A forgotten disease: Pelvic congestion syndrome as a cause of chronic lower abdominal pain. PLoS One. 2019;14(4):e0213834. https://doi.org/10.1371/journal.pone.0213834.

14. Romero A., Hohbein J., Ross S.E.N. Superficial thrombosis of pelvic congestion syndrome mimicking pelvic abscess. Clin Pract Cases Emerg Med. 2019;3(3):237-9. https://doi.org/10.5811/cpcem.2019.4.42527.

15. Bookwalter C.A., VanBuren W.M., Neisen M.J., Bjarnason H. Imaging appearance and nonsurgical management of pelvic venous congestion syndrome. Radiographics. 2019;39(2):596-608. https://doi.org/10.1148/rg.2019180159.

16. Akhmetzyanov R.V., Bredikhin R.A., Fomina E.E., Ignatyev I.M. Endovascular treatment of women with pelvic varicose veins due to post-thrombotic iliac vein lesion. [Endovaskulyarnoe lechenie pacientok s varikoznoj bolezn'yu taza, obuslovlennoj posttromboticheskim porazheniem podvzdoshnyh ven]. Angiologiya i sosudistaya hirurgiya. 2019;25(4):92-101. (In Russ.). https://doi.org/10.33529/ANGIO2019402.

17. Meissner M.H., Khilnani N.M., Labropoulos N. et al. The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders. J Vasc Surg Venous Lymphat Disord. 2021;9(3):568-84. https://doi.org/10.1016/j.jvsv.2020.12.084.

18. Arnoldussen C.W., de Wolf M.A., Wittens C.H. Diagnostic imaging of pelvic congestion syndrome. Phlebology. 2015;30(1 Suppl):67-72. https://doi.org/10.1177/0268355514568063.

19. Jayaraj A., Raju S. Three-dimensional computed tomography venogram enables accurate diagnosis and treatment of patients presenting with symptomatic chronic iliofemoral venous obstruction. J Vasc Surg Venous Lymphat Disord. 2021;9(1):73-80.e1. https://doi.org/10.1016/j.jvsv.2020.07.012.

20. Meneses L.Q., Uribe S., Tejos C. et al. Using magnetic resonance phasecontrast velocity mapping for diagnosing pelvic congestion syndrome. Phlebology. 2011;26(4):157-61. https://doi.org/10.1258/phleb.2010.010049.

21. Coakley F.V., Varghese S.L., Hricak H. CT and MRI of pelvic varices in women. J Comput Assist Tomogr. 1999;23(3):429-34. https://doi.org/10.1097/00004728-199905000-00018.

22. Lemasle P., Greiner M. Duplex ultrasound investigation in pelvic congestion syndrome: technique and results. Phlebolymphology. 2017;24(2):79-87.

23. Labropoulos N., Jasinski P.T., Adrahtas D. et al. A standardized ultrasound approach to pelvic congestion syndrome. Phlebology. 2017;32(9):608-19. https://doi.org/10.1177/0268355516677135.

24. Pyra K., Wozniak S., Drelich-Zbroja A. et al. Evaluation of effectiveness of embolization in pelvic congestion syndrome with the new vascular occlusion device (ArtVentive EOS™): preliminary results. Cardiovasc Intervent Radiol. 2016;39(8):1122-7. https://doi.org/10.1007/s00270-016-1380-8.

25. Brown C.L., Rizer M., Alexander R. et al. Pelvic congestion syndrome: systematic review of treatment success. Semin Intervent Radiol. 2018;35(1):35-40. https://doi.org/10.1055/s-0038-1636519.

26. Sokolov A.A., Tsvetkova N.V. Ovarian varicose veins - diagnosis and treatment. [Varikoznoe rasshirenie ovarial'nyh ven - diagnostika i lechenie]. SonoAce International (russkaya versiya). 1999;(4):19-22. (In Russ.).

27. Sharipov G.N., Ismoilov M.M., Shaimonov A.Kh. et al. Varicose veins of the small pelvis, polycystic ovarian disease and other comorbidities in women with tubal pregnancy. [Varikoznaya bolezn' ven malogo taza, polikistoz yaichnikov i drugaya soputstvuyushchaya patologiya u zhenshchin s trubnoj beremennost'yu]. Vestnik Smolenskoj gosudarstvennoj medicinskoj akademii. 2019;18(1):99-102. (In Russ.).

28. Marizoeva M.M., Nematzoda O., Sultanov D.D. et al. Course of pregnancy in women with varicose desease. [Techenie beremennosti u zhenshchin s varikoznoj bolezn'yu]. Vestnik Avicenny. 2017;(2):142-6. (In Russ.). https://doi.org/10.25005/2074-0581-2017-19-2-142-146.


Review

For citations:


Novikova N.Yu., Tsibizova V.I., Puzdriak P.D., Komlichenko E.V., Tsnobiladze I.G., Malushko A.V., Ivanov M.A., Chizhova K.A., Bondarenko P.B., Kositsyna I.M., Blinov D.V. Pelvic congestion syndrome as a cause of chronic pelvic pain. Obstetrics, Gynecology and Reproduction. 2021;15(4):451-460. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.236

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)