Diagnostic Imaging and Endovascular Treatment of Pelvic Congestion Syndrome

Abstract

Chronic pelvic pain is a common health problem among women and is defined as non-cyclic pelvic pain of more than 6 months’ duration (Black et al, 2010).

The presence of a vascular cause of pelvic pain was first mooted in the late 19th century (Liddle and Davies, 2007).

This condition, which has become known as the pelvic congestion syndrome (PCS), only gained widespread acceptance after Beard et al.’s work of the 1980s, which showed 91% of women with chronic pelvic pain to have identifiable pelvic varicosities (Liddle and Davies, 2007).

The precise etiology of pelvic congestion syndrome (PCS) remains poorly understood but is believed to be multifactorial having mechanical, hormonal and psychological components (Robertson and McCuaig, 2013).

Radiological imaging is essential in the assessment of PCS and is frequently used to confirm the clinical suspicion of this condition. Non-invasive modalities are recommended as a first-line investigation; however, the gold standard remains selective venography (Osman et al, 20