Annals of vascular surgery · 2026
Pelvic Congestion Syndrome: Retrospective Analysis Single-Institution Series Reported in Latin America (2019-2023).
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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García Valencia Luis Fernando, Bernal Andres Felipe, Bautista Camilo, García Allison, Botero Isabela García, Botero Jacobo García
Аннотация
BACKGROUND: Pelvic congestion syndrome (PCS) is a common yet frequently underdiagnosed condition in women with chronic pelvic pain. Endovascular treatment allows both confirmation of the diagnosis and treatment of the main venous abnormalities associated with the syndrome. This study aimed to describe the clinical and radiological characteristics of patients diagnosed with PCS and to evaluate the outcomes of endovascular treatment with gonadal vein coil embolization.
METHODS: Retrospective single arm observational study was conducted of patients over 18 years treated for PCS, between 2019 and 2023. Diagnosis was defined by the presence of pelvic symptoms and by imaging findings (evidence of findings suggestive of pelvic congestion syndrome in at least 1 study). All patients underwent phlebography and cavography prior to embolization, and according to the angiographic findings endovascular gonadal vein embolization using coils. Clinical parameters, procedural details, and follow-up were reviewed. Each variable was analyzed independently using the number of patients with available information for that variable as the denominator.
RESULTS: A total of 1,417 patients were collected, where 123 patients who were treated exclusively for venous compression syndrome were excluded. Consequently, 1294 patients were included, 77.7% were multiparous, 56% reported dyspareunia (mean Visual Analog Scale (VAS): 6.6), and 50.8% reported dysmenorrhea (mean VAS: 6.9). The average ovarian vein diameter was 6.60 mm ± 1.14 mm. Gonadal embolization was performed in 90.3% of patients. Symptom improvement was reported in 86.8%, among those with complete VAS data, dyspareunia decreased by 70.8% and dysmenorrhea by 72.4%, with statistically significant reductions in both symptoms. The overall complication rate was 1.7%, minor complication rate was 1.11%, and major complication rate was 0.59%.
CONCLUSION: PCS is a frequently encountered condition in vascular surgery practice. In our experience, treatment of pelvic congestion syndrome with gonadal embolization leads to symptomatic improvement. Complications, although rare, can occur and must be identified early for treatment.
METHODS: Retrospective single arm observational study was conducted of patients over 18 years treated for PCS, between 2019 and 2023. Diagnosis was defined by the presence of pelvic symptoms and by imaging findings (evidence of findings suggestive of pelvic congestion syndrome in at least 1 study). All patients underwent phlebography and cavography prior to embolization, and according to the angiographic findings endovascular gonadal vein embolization using coils. Clinical parameters, procedural details, and follow-up were reviewed. Each variable was analyzed independently using the number of patients with available information for that variable as the denominator.
RESULTS: A total of 1,417 patients were collected, where 123 patients who were treated exclusively for venous compression syndrome were excluded. Consequently, 1294 patients were included, 77.7% were multiparous, 56% reported dyspareunia (mean Visual Analog Scale (VAS): 6.6), and 50.8% reported dysmenorrhea (mean VAS: 6.9). The average ovarian vein diameter was 6.60 mm ± 1.14 mm. Gonadal embolization was performed in 90.3% of patients. Symptom improvement was reported in 86.8%, among those with complete VAS data, dyspareunia decreased by 70.8% and dysmenorrhea by 72.4%, with statistically significant reductions in both symptoms. The overall complication rate was 1.7%, minor complication rate was 1.11%, and major complication rate was 0.59%.
CONCLUSION: PCS is a frequently encountered condition in vascular surgery practice. In our experience, treatment of pelvic congestion syndrome with gonadal embolization leads to symptomatic improvement. Complications, although rare, can occur and must be identified early for treatment.