Geburtshilfe Frauenheilkd 2016; 76 - P168
DOI: 10.1055/s-0036-1593045

Chronic lower abdominal pain is commonly associated with pelvic congestion syndrome

A Jurga-Karwacka 1, GM Karwacki 2, FD Schwab 1, A Schötzau 1, C Zech 2, V Heinzelmann-Schwarz 1
  • 1Frauenklinik, Universitätsspital Basel, Basel, Schweiz
  • 2Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel, Basel, Schweiz

Aims: Pelvic congestion syndrome (PCS) is defined as chronic pelvic pain (CPP) due to incompetence of ovarian veins (OV) and parauterine varicosity (PV). The aim of this study was to investigate the prevalence of symptomatic dilated OV/PV in premenopausal (PreMP) and postmenopausal (PMP) women. Additionally, we wanted to define diagnostic criteria that allow for simplified characterization of patients with PCS.

Methods: We retrospectively reassessed abdominal CT scans performed in Radiology Department from 01.01.2013 till 30.06.2014. We measured OV diameters and documented PV on each side. OV were considered dilated when they measured ≥6 mm in axial plane. The findings were correlated with clinical parameters as documented in the gynecological files.

Results: We reassessed CT scans of 2402 women (567 PreMP, mean age 37 ± 8; 1835 PMP, mean age 70 ± 12). We found dilated OV/PV in 294 (12%) patients (21% PreMP, 10% PMP). Undiagnosed CPP was documented in 54 (18%) of them (38% PreMP, 6% PMP with dilated OV/PV). The prevalence of PCS in our study was 2% (8% PreMP, 0,5% PMP). CPP was mainly localized in lower abdomen, back and flanks, and was accompanied by haematuria, dysuria, and pollakisuria but not by infection (p < 0,05, respectively). Asymptomatic dilated OV/PV were found in 240 (10%) patients (13% PreMP, 9% PMP).

On a tree-based model 80% women with CPP that were premenopausal, parous, with haematuria had dilated OV/PV.

Conclusions: Awareness of PCS needs to be raised among physicians involved in the diagnostic process of CPP., as PCS seems to be an underdiagnosed and undertreated disease.