PDF(Pubmed)
Abstract：
Pelvic venous congestion syndrome (PVCS) is a common, but underdiagnosed, cause of chronic pelvic pain (CPP) in women.PVCS occurs usually, but not exclusively, in multiparous women. It is characterized by chronic pelvic pain of more than six months duration with no evidence of inflammatory disease.The patients present to general practitioners, gynaecologists, vascular specialists, pain specialists, gastroenterologists and psychiatrists. Pain of variable intensity occurs at any time but is worse in the pre-menstrual period, and is exacerbated by walking, standing, and fatigue. Post coital ache, dysmenorrhea, dyspareunia, bladder irritability and rectal discomfort are also common. Under-diagnosis of this condition can lead to anxiety and depression.A multidisciplinary approach in the investigation and management of these women is vital.Non-invasive imaging (US, CT, MRI) are essential in the diagnosis and exclusion of other conditions that cause CPP as well in the definitive diagnosis of PVCS. Trans-catheter venography remains the gold standard modality for the definitive diagnosis and is undertaken as an immediate precursor to ovarian vein embolization (OVE). Conservative, medical and surgical management strategies have been reported but have been superseded by OVE, which has a reported technical success rates of 96-100%, low complication rates and long-term symptomatic relief in between 70-90% of cases.The condition, described in this paper as PVCS, is referred to by a wide variety of other terms in the literature, a cause of confusion.There is a significant body of literature describing the syndrome and the excellent outcomes following OVE however the lack of prospective, multicentre randomized controlled trials for both investigation and management of PVCS is a significant barrier to the complete acceptance of both the existence, investigation and management of the condition.
摘要：
盆腔静脉淤血综合征(PVCS)是一种常见的,但诊断不足,女性慢性盆腔疼痛（CPP）的原因。PVCS通常发生，但不限于此,在多胎妇女中。其特征是慢性盆腔疼痛持续时间超过六个月，没有炎症性疾病的证据。全科医生面前的病人，妇科医生,血管专家，疼痛专家,胃肠病学家和精神病医生。不同强度的疼痛发生在任何时间，但在月经前期更为严重，走路会加剧这种情况，站立,和疲劳。性交后疼痛，痛经,性交困难,膀胱易怒和直肠不适也很常见。这种情况的诊断可能导致焦虑和抑郁。在这些妇女的调查和管理中采用多学科方法至关重要。非侵入性成像(美国，CT,MRI）对于诊断和排除引起CPP的其他疾病以及明确诊断PVCS至关重要。经导管静脉造影仍然是明确诊断的金标准方式，并且是卵巢静脉栓塞（OVE）的直接前体。保守,据报道，医疗和外科管理策略已被OVE取代，据报道，技术成功率为96-100%，在70-90%的病例中，低并发症发生率和长期症状缓解。条件,本文描述为PVCS，在文献中被各种各样的其他术语引用，混乱的原因。有大量文献描述了OVE后的综合征和良好的结果，但是缺乏前瞻性，用于PVCS的调查和管理的多中心随机对照试验是完全接受两者存在的重要障碍，状况的调查和管理。
