Original Article

Chronic pelvic pain associated with pelvic vein incompetence

  • LIANA PLES
  • ADINA TEODORA CORBU
  • DENISA OANA BALALAU
  • OMINA MARINA SIMA
  • OCTAVIAN GABRIEL OLARU
  • ANCA DANIELA STANESCU

Pelviperineology 2018;37(4):123-126

Introduction:

Chronic pelvic pain (CPP) is a spectrum of symptoms including pain, tension in the lower abdomen, dyspareunia, dyskinesia, dysuria or dysmenorrhea. The conditions responsible for CPP are various but in more than 60% cases the diagnosis cannot be established. Ultrasound is a useful tool in the evaluation of those patients.

Material and method:

We retrospectively evaluated the ultrasound scans and physical examination of the patients who presented in our clinic for pelvic pain between Jan 2016-Jan 2018. We retrieved only the patients who reported at least one of the symptoms compatible with CPP and reviewed the files. A chart with relevant characteristics -age, parity, main complaints, transvaginal ultrasound was completed. We searched for abnormal pelvic vascular patterns suggestive for incontinent pelvic veins.

Results:

In a two years period 2437 women asked for genital examination in “Bucur” Obstetrics and Gynecology Clinic. For 326 women abdominal pain was the main complaint but only 128 met the criteria for CPP. In 31 of them ultrasound transvaginal scan revealed abnormal vascular patterns of the pelvic veins (enlarged, tortuous vessels) suggestive for congestion and incontinent veins.

Conclusions:

Congestion of the pelvic veins can be responsible for about 30% of the CPP especially in multiparous women. Ultrasound using Doppler is useful in order to establish incontinence of the pelvic veins.

Keywords: Chronic pelvic pain,Doppler ultrasound,Pelvic congestion syndrome,Pelvic veins diameter,Pelvic veins incompetence