Evidenzbasierung von Beckenvenensyndrom bzw. symptomatischer Adnexvarikosis – Ergebnisse einer Literaturrecherche

Chronische Schmerzsymptome sind mit hohen Anforderungen an die Anamneseerhebung, die Diagnostik und die mögliche Therapie verbunden. Neben der Beschwerdedauer sind die genaue Schmerzlokalisation, der Schmerzcharakter, der Zeitpunkt des Auftretens und Situationen, die zu einer Verbesserung oder Verschlimmerung führen, sowie psychische Co-Faktoren (insbesondere Depressionen und Ängste) von Bedeutung. Die Intensität der Schmerzwahrnehmung ist dabei immer subjektiv und kann durch kein Untersuchungsverfahren objektiviert werden. Eine seltene Ursache von chronischen Unterbauchschmerzen bei Frauen kann das Beckenvenensyndrom (BVS) sein. Der aktuelle Forschungsstand zum BVS, dessen Ursachen, Folgen und mögliche Therapieoptionen wurden im Rahmen einer selektiven Literaturrecherche eruiert.

• Literatur

• 1 Bittelbrunn CC, de Fraga R, Martins C. et al. Pelvic floor physical therapy and mindfulness: approaches for chronic pelvic pain in women—a systematic review and meta-analysis. Arch Gynecol Obstet 2023; 307: 663-672
• 2 Champaneria R, Shah L, Moss J. et al. The relationship between pelvic vein incompetence and chronic pelvic pain in women: systematic reviews of diagnosis and treatment effectiveness. Health Technol Assess 2016; 20: 1-108
• 3 Borghi C, Dell’Atti L. Pelvic congestion syndrome: the current state of the literature. Arch Gynecol Obstet 2016; 293: 291-301
• 4 Sulakvelidze L, Tran M, Kennedy R. et al. Presentation patterns in women with pelvic venous disorders differ based on age of presentation. Phlebology 2021; 36: 135-144
• 5 Walsh M, Ahern M, Zahiri N. et al. An Inconvenient Truth: The Added Value of Transvaginal Imaging of the Internal Iliac and Adnexal Veins for Pelvic Congestion Syndrome. J Vasc Ultrasound 2019; 3: 113-115
• 6 Nanavati R, Jasinski P, Adrahtas D. et al. Correlation between pelvic congestion syndrome and body mass index. J Vasc Ultrasound 2018; 67: 536-541
• 7 Kelly DM, Sanford D, Stoughton J. A Study Comparing the Results of Duplex Ultrasound and Magnetic Resonance Venography to Diagnose Pelvic Vein Congestion in Conjunction with a Compression Syndrome. J Vasc Ultrasound 2016; 40: 14-19
• 8 Malgor RD, Adrahtas D, Spentzouris G. et al. The role of duplex ultrasound in the workup of pelvic congestion syndrome. J Vasc Surg Venous Lymphat Disord 2014; 2: 34-38
• 9 Ignacio Leal Lorenzo J, Gallardo Madueño G, Alcázar Peral A. et al. Bilateral Ovarian Vein Embolisation from a Unilateral Basilic Approach with n-2-Butyl Cyanoacrylate and Crossover Technique for Pelvic Congestion Syndrome. Eur J Vasc Endovasc Surg 2022; 63: 163-164
• 10 Laborda A, Medrano J, De Blas I. et al. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale (VAS) Long-Term Follow-up Clinical Evaluation in 202 Patients. Cardiovasc Intervent Radiol 2013; 36: 1006-1014
• 11 Guirola JA, Sánchez-Ballestin M, Sierre S. et al. A Randomized Trial of Endovascular Embolization Treatment in Pelvic Congestion Syndrome: Fibered Platinum Coils versus Vascular Plugs with 1-Year Clinical Outcomes. J Vasc Interv Radiol 2018; 29: 45-53
• 12 Valero I, Garcia-Jimenez R, Valdevieso P. et al. Identification of Pelvic Congestion Syndrome Using Transvaginal Ultrasonography. A Useful Tool. Tomography 2022; 8: 89-99
• 13 Attia NM, Sayed MA, Galal Mohamed HE. et al. The role of MR venography with time-resolved imaging in diagnosis of pelvic congestion syndrome. Egypt J Radiol Nucl Med 2022; 53: 19
• 14 Awad AS, Taha MMM, Manaf MHA. et al. Role of multi-detector CT venography in evaluation of pelvic congestion syndrome. Egypt J Radiol Nucl Med 2020; 51: 159
• 15 Osman AM, Mordi A, Khattab R. Female pelvic congestion syndrome: how can CT and MRI help in the management decision?. Br J Radiol 2021; 94: 20200881
• 16 Hocquelet A, Le Bras Y, Balian E. et al. Evaluation of the efficacy of endovascular treatment of pelvic congestion syndrome. Diagn Interv Imaging 2014; 95: 301-306
• 17 Senechal Q, Echegut P, Bravetti M. et al. Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale Follow-Up. Front Cardiovasc Med 2021; 8: 751178
• 18 Nasser F, Cavalcante RN, Affonso BB. et al. Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome. Int J Gynaecol Obstet 2014; 125: 65-68
• 19 Herrera-Betancourt AL, Villegas-Echeverri JD, López-Jaramillo JD. et al. Sensitivity and specificity of clinical findings for the diagnosis of pelvic congestion syndrome in women with chronic pelvic pain. Phlebology 2018; 33: 303-308
• 20 Chen H, Wu Z, Wu Z. et al. Proximal coil occlusion preceding distal sclerotherapy in patients with pelvic congestion syndrome: A multicenter, retrospective study. J Vasc Surg Venous Lymphat Disord 2023; 11: 149-155
• 21 Dos Santos SJ, Holdstock JM, Harrison CC. et al. Ovarian Vein Diameter Cannot Be Used as an Indicator of Ovarian Venous Reflux. Eur J Vasc Endovasc Surg 2015; 49: 90-94
• 22 Pyra K, Woźniak S, Roman T. et al. Evaluation of effectiveness of endovascular embolisation for the treatment of pelvic congestion syndrome – preliminary study. Ginekol Pol 2015; 86: 346-351
• 23 Gavrilov SG, Karalkin AV, Turischeva OO. Compression treatment of pelvic congestion syndrome. Phlebology 2018; 33: 418-424
• 24 Bałabuszek K, Michał Toborek M, Pietura R. Comprehensive overview of the venous disorder known as pelvic congestion syndrome. Ann Med 2022; 54: 22-36
• 25 Gavrilov S, Sazhin A, Krasavin G. et al. Comparative analysis of the efficacy and safety of endovascular and endoscopic interventions on the gonadal veins in the treatment of pelvic congestion syndrome. J Vasc Surg Venous Lymphat Disord 2021; 9: 178-186
• 26 Bundesärztekammer. Wissenschaftlicher Beirat der Bundesärztekammer „Plazebo in der Medizin“. Dtsch Arztebl 2010; 107: B 1253