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Pelvic Congestion Syndrome

Approximately 15% of women between 18 - 50 years of age have symptoms of pelvic congestion, characterized by heavy or dull aching deep pelvic pain, sometimes with dyspareunia, dysmenorrhea and dysuria. Symptoms are characteristically worsened by prolonged standing. Physical exam may demonstrate varices of the external genitalia and lower extremities. Although the etiology is not known, patients are typically multiparous, and have absent or incompetent valves in the left ovarian vein. Imaging demonstrates retrograde flow in a dilated left ovarian vein, with pelvic varices.

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  1. Eliahou R, Sosna J, Bloom AI. Between a rock and a hard place: clinical and imaging features of vascular compression syndromes. Radiographics 2012; 32:E33-49. PubMed link
  2. Freedman J, Ganeshan A, Crowe PM. Pelvic congestion syndrome: the role of interventional radiology in the treatment of chronic pelvic pain. Postgrad Med J 2010; 86:704-710. PubMed link
  3. Ganeshan A, Upponi S, Hon LQ, Uthappa MC, Warakaulle DR, Uberoi R. Chronic pelvic pain due to pelvic congestion syndrome: the role of diagnostic and interventional radiology. Cardiovasc Intervent Radiol 2007; 30:1105-1111. PubMed link
  4. Umeoka S, Koyama T, Togashi K, Kobayashi H, Akuta K. Vascular dilatation in the pelvis: identification with CT and MR imaging. Radiographics 2004; 24:193-208. PubMed link