Role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome

Ahmed A Baz

doi:10.1186/s43055-019-0099-3

Abstract

BackgroundFor evaluation the role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome, fifty patients with pelvic congestion syndrome were included in the current research. All were evaluated by trans-abdominal and trans-perineal venous duplex.ResultsAn incompetent left gonadal vein was detected in all cases with a mean diameter (± SD) = 7.9 ± 1.1 mm. The right gonadal vein was incompetent in 4 cases (8%) with a mean diameter (± SD) 5.9 ± 0.4 mm.A refluxing proximal internal iliac vein was detected in 3cases (6%). Left renal vein nutcracker was present in 41cases (82%) while the left common iliac vein compression was present in 3 cases (6%).Vulvoperineal varicosities were seen in all cases {right side = (36%, n = 18), left side = (30%, n = 15), and bilateral = (34%, n = 17)}.Thigh extension of the vulvoperineal varicosities was present in (74%, n = 37).Round ligament varicosities were present in (6%, n = 3).ConclusionsTrans-abdominal and trans-perineal venous duplex offer a simple, noninvasive, and quick technique that can help in an accurate evaluation of the ovarian vein reflux, diameters as well as the presence of vulvoperineal, and round ligament varicosities, Moreover, it is useful in the assessment of the left renal and iliac veins compression.

Highlights

For evaluation the role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome, fifty patients with pelvic congestion syndrome were included in the current research
Many predisposing factors had been associated with the condition including multiparty, obesity, and venous outflow obstruction; the hormonal status, as the decline in the estrogen levels in the premenopausal women had been described as a contributing factor that could lead to a weakness of the venous walls [3]
Diagnosis of Pelvic congestion syndrome (PCS) is usually based on clinical examination and the confirmatory noninvasive imaging studies including trans-abdominal duplex ultrasound, transvaginal duplex ultrasound, computed tomography (CT) venography, and magnetic resonance (MR) venography

Summary

Introduction

For evaluation the role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome, fifty patients with pelvic congestion syndrome were included in the current research. Pelvic congestion syndrome (PCS) is a condition which is characterized by chronic noncyclical (typically dull and aching) pelvic pain lasting for more than 6 months. It can affect the females during their childbearing as well as the premenopausal periods; it usually results from the venous insufficiency of either gonadal or pelvic veins. Many gynecological problems can contribute to chronic pelvic pain in females including endometriosis, adenomyosis, uterine fibroids, pelvic adhesions, uterine prolapse, and malignancies; other non-. Many predisposing factors had been associated with the condition including multiparty, obesity, and venous outflow obstruction; the hormonal status, as the decline in the estrogen levels in the premenopausal women had been described as a contributing factor that could lead to a weakness of the venous walls [3].

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