Table of contents
Pelvic congestion syndrome
The following summarized guidelines for the evaluation and management of pelvic congestion syndrome are prepared by our editorial team based on guidelines from the European Society for Vascular Surgery (ESVS 2022), the American College of Radiology (ACR 2021), and the Society for Vascular Surgery (SVS/AVF 2011).
1.Screening and diagnosis
Differential diagnosis: exclude other causes of pain in female patients with pelvic pain and a clinical suspicion of pelvic venous disorders.
Diagnostic imaging: as per ESVS 2022 guidelines, obtain specific duplex ultrasound assessment of pelvic escape points in patients presenting with symptomatic varicose veins with possible pelvic origin.
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Local procedures: as per ESVS 2022 guidelines, consider performing local procedures for varicose veins and related pelvic escape points as an initial therapeutic approach in patients with varicose veins of pelvic origin without pelvic symptoms requiring treatment.
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Pelvic vein embolization
Indications for surgery: consider performing surgical ligation and excision of ovarian veins to treat reflux if less invasive treatment is not available or has failed.