Imaging-Based Approach to Venous-Origin Chronic Pelvic Pain

Area of Science:

• Vascular Medicine
• Radiology
• Gynecology

Background:

• Chronic pelvic pain (CPP) affects many women globally, with pelvic venous disorders (PeVD) being an underdiagnosed cause.
• PeVD involves venous reflux or obstruction, leading to venous hypertension, congestion, and pain, often presenting non-specifically.

Purpose of the Study:

• To review the pathophysiology, diagnostic imaging modalities, and evolving management strategies for PeVD in the context of CPP.
• To emphasize the importance of early recognition and multidisciplinary intervention for PeVD.

Main Methods:

• Review of current literature on PeVD and CPP.
• Discussion of advanced imaging techniques including ultrasound, CT/MR venography, and selective venography.
• Exploration of minimally invasive endovascular therapies and surgical interventions.

Main Results:

• Advanced imaging is crucial for diagnosing PeVD and differentiating it from other CPP causes.
• Selective venography is the gold standard for assessing reflux and guiding interventions.
• Multidisciplinary approaches and emerging endovascular techniques improve patient outcomes.

Conclusions:

• PeVD is a significant, often overlooked, cause of CPP requiring increased clinical awareness and standardized diagnostic criteria.
• Early diagnosis and intervention, utilizing advanced imaging and minimally invasive treatments, are key to managing PeVD effectively.
• A collaborative approach among specialists is essential for comprehensive patient care.