Symptoms and quality of life assessment after coil and foam embolization in patients with venous-origin chronic pelvic pain (VO-CPP) - a subgroup of pelvic venous disorders (PeVD).

BACKGROUND

Venous-Origin Chronic Pelvic Pain (VO-CPP), a subgroup of Pelvic Venous Disorders (PeVD) can significantly affect Quality of Life (QoL). Previous papers have highlighted the lack of evaluations measuring QoL of patients before and after embolization. The aim of this study was to evaluate the effectiveness of embolization in reducing a variety of symptoms and improving QoL in patients with VO-CPP.

METHODS

A prospective analysis of 40 female patients (mean 36.9 years) diagnosed with VO-CPP, undergoing venous embolization between June 2020 and May 2023 was conducted. Patients with extrinsic compressions, other pelvic conditions, and S3V3 without S2 in SVP Classification were excluded. Patients were evaluated before and after treatment at mid-term (MT) (9.4 ± 5.1 months) and long-term (LT) (29.6 ± 6.94 months). The severity of 12 different symptoms were assessed using VAS scale (pelvic, postcoital, standing, back, hip, leg and abdominal pain; nausea frequency, urinary discomfort, sleep disturbance and dysmenorrhoea), while QoL was measured using the SF-36 questionnaire. Patient satisfaction was assessed using the Likert scale.

RESULTS

Significant reductions in all measured symptoms were observed between pre-treatment and MT and LT follow-ups (p < 0.0001). No statistically significant differences were found between MT and LT scores, indicating a sustained relief. The greatest benefits were observed in reducing daytime pelvic pain (6.25 ± 1.93 to 2.49 ± 2.47), standing (7.43 ± 1.65 to 3.41 ± 2.43) and postcoital pain (6.40 ± 2.63 to 2.54 ± 2.22). QoL scores in both physical and mental health showed statistically significant and sustained improvement after the procedure. Most patients were satisfied with the procedure (81%), with 86% willing to undergo it again and 89% to recommend it.

CONCLUSION

Embolization provides significant, sustained improvements in symptom relief while enhancing QoL in VO-CPP patients. Randomized controlled trials are needed to confirm these effects and exclude a placebo response.