Role of multi-detector CT venography in evaluation of pelvic congestion syndrome

Ahmad Sayed Awad,Mohammed Hamam Abd Manaf,Mohammed Medhat Mohammed Taha,Mostafa Mahmoud Mohamad Gad,Shady Nabil Mashhour

doi:10.1186/s43055-020-00280-5

Ahmad Sayed Awad, Mohammed Hamam Abd Manaf + Show 3 more

Open Access

https://doi.org/10.1186/s43055-020-00280-5

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Abstract

BackgroundPelvic congestion syndrome (PCS) is a problematic cause of chronic pelvic pain in women. It is thought to result from venous insufficiency of either ovarian or pelvic veins. Patients also present a variety of symptoms including dysuria and dyspareunia as well as vulva and buttock varicosities. The aim of this study is to evaluate the efficacy of multi-detector CT (MDCT) in diagnosis of PCS. Two hundred patients were included in our study and underwent CT venography of the abdomen and pelvis.ResultsWe performed a prospective comparative study conducted on 200 patients. Thirty patients (15%) were diagnosed as PCS. There were congestion of the ovarian venous plexus and uterine venous engorgement in all patients. Filling of the veins across the midline was noted in 10 patients and filling of the vulval and thigh varicosities was noted in 3 patients. Ten patients had right ovarian vein dilatation; 12 patients had left ovarian vein dilatation; while 8 patients had bilateral ovarian vein dilatation. The right ovarian vein mean diameter (± SD) = 7.1 ± 0.8 mm; while the left ovarian vein mean diameter (± SD) = 7.6 ± 1 mm. Left ovarian venous reflux was found in 6 cases while no pathological reflux depicted on right side.ConclusionsCT venography is considered as one of the initial investigations for the diagnosis of PCS in female patients with chronic pelvic pain making the further assessment by ovarian venography is for interventional management of diagnosed cases.

Highlights

Pelvic congestion syndrome (PCS) is a problematic cause of chronic pelvic pain in women
The aim of this study is to evaluate the role of multi-detector computed tomography (CT) (MDCT) venography in the workup of the cases presented by chronic pelvic pain to detect the cause and the ability to diagnose pelvic congestion syndrome
P values less than 0.05 (5%) was considered to be statistically significant. This is a prospective comparative study conducted on 200 patients with chronic pelvic pain; to assess the role of MDCT venography in evaluation of pelvic congestion syndrome

Summary

Introduction

Pelvic congestion syndrome (PCS) is a problematic cause of chronic pelvic pain in women. Chronic pelvic pain (CPP) is a common irritating symptom in females and represents a common cause of gynecologic referral [1]. Pelvic congestion syndrome (PCS) is a known cause of chronic pelvic pain. It usually affects women during their childbearing and premenopausal periods. It usually results from the venous insufficiency of either ovarian or Because the etiology of pelvic vessel dilatation is probably multifactorial (e.g., hormonal and mechanical factors), PCS may occur along with other serious diseases, so imaging these vasculatures has a crucial role in screening [5]

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