Table of contents

Pelvic congestion syndrome


Key sources

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). ...
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Screening and diagnosis

Differential diagnosis: as per ESVS 2022 guidelines, exclude other causes of pain in female patients with pelvic pain and a clinical suspicion of pelvic venous disorders.
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Diagnostic investigations

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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Therapeutic procedures

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

Surgical interventions

Indications for surgery: as per AVF/SVS 2011 guidelines, consider performing surgical ligation and excision of ovarian veins to treat reflux if less invasive treatment is not available or has failed.