Abstract
Background Pelvic venous disorders (PeVD) are an underdiagnosed cause of chronic pelvic pain
in women. They are caused by venous insufficiency of the pelvic or ovarian veins,
leading to the development of mainly periuterine and periovarian varices. It is a
progressive disease if left untreated and can cause swelling, dyspareunia, dysmenorrhea,
and other symptoms, some non-specific, that affect the patient’s quality of life.
Interventional therapies are a central component of the treatment of PeVD, with a
variety of techniques available for both diagnosis and treatment.
Method This review provides an overview of the pathophysiologic background, diagnosis, and,
most importantly, interventional treatment options for PeVD.
Results There is a lack of standardized nomenclature and internationally accepted diagnostic
criteria for PeVD as well as randomized controlled trials demonstrating clinical success.
However, in clinical trials, endovascular therapy for PeVD has been shown to be safe
and effective. This review presents the various interventional techniques for the
treatment of PeVD, including embolization, stenting, and sclerotherapy.
Conclusion The importance of PeVD is receiving growing recognition. Recent advances, such as
the development of the Symptoms-Varices-Pathophysiology (SVP) classification, provide
an impetus to standardize nomenclature and are the first step toward systematizing
disease management. Interventional therapies provide a safe and tailored minimally
invasive treatment option for patients with PeVD.
Key Points
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Pelvic venous disorders are an underdiagnosed condition with frequently delayed diagnosis
and debilitating symptoms.
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Until now, the PeVD nomenclature has been imprecise, with terms like May-Thurner syndrome/Nutcracker
syndrome.
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Interventional approaches are effective and play a central role in PeVD treatment.
Citation Format
Keywords
pelvic venous disorders (PeVD) - pelvic congestion syndrome - nutcracker syndrome
- may thurner syndrome - endovascular therapy
