Diagnosis and Management of Pelvic Venous Disorders: AJR Expert Panel Narrative Review.
Review
Overview
abstract
Pelvic venous disorders (PeVD), previously known by various imprecise terms including pelvic congestion syndrome, has historically been underdiagnosed as a cause of chronic pelvic pain (CPP), a significant health problem associated with reduced quality of life. However, progress in the field has helped to provide heightened clarity with respect to definitions relating to PeVD, and evolution in algorithms for PeVD workup and treatment has been accompanied by new insights into causes of a pelvic venous reservoir and associated symptoms. At present, ovarian and pelvic vein embolization, as well as endovascular stenting of common iliac venous compression, should both be considered as management options for PeVD. Both treatments have been shown to be safe and effective for patients with CPP of venous origin across, regardless of age. Current therapeutic protocols for PeVD exhibit significant heterogeneity due to limited prospective randomized data and evolving understanding of factors driving successful outcomes; forthcoming clinical trials are anticipated to improve understanding of CPP of venous origin as well as algorithms for PeVD management. This AJR Expert Panel Narrative Review provides a contemporary update relating to PeVD, summarizing the entity's current classification, diagnostic workup, endovascular treatments, management of persistent or recurrent symptoms, and future research directions.
