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Pelvic vein incompetence: clinical perspectives
Chronic pelvic pain (CPP) affects 24% of premenopausal women, accounts for 20%–30% of UK gynecology outpatient appointments, and has an annual pan-European economic cost of €3.8 billion. Despite extensive investigation, often including laparoscopy, up to 55% of women do not receive a diagnosis and e...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708198/ https://www.ncbi.nlm.nih.gov/pubmed/29225469 http://dx.doi.org/10.2147/VHRM.S132827 |
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author | Riding, David M Hansrani, Vivak McCollum, Charles |
author_facet | Riding, David M Hansrani, Vivak McCollum, Charles |
author_sort | Riding, David M |
collection | PubMed |
description | Chronic pelvic pain (CPP) affects 24% of premenopausal women, accounts for 20%–30% of UK gynecology outpatient appointments, and has an annual pan-European economic cost of €3.8 billion. Despite extensive investigation, often including laparoscopy, up to 55% of women do not receive a diagnosis and endure persistent symptoms. In these patients, clinical management focuses on symptom control rather than treatment. It is possible that pelvic vein incompetence (PVI) is a cause of CPP, although the quality of studies investigating an association is generally low. PVI may develop during and after pregnancy, as uterine blood flow increases significantly, pushing venous valve leaflets apart, and enabling retrograde venous flow. Analogies with varicose veins of the lower limb are helpful, and symptoms are similar. Women with symptomatic PVI report a dull pelvic ache that is worse on standing and sitting and persists throughout the day. It can be relieved by lying down. Early treatments for PVI included laparoscopic ligation; however, since the advent of endovascular occlusive techniques, treatments have lower risk and lower cost, and can be undertaken without sedation or anesthetic. However, there have been no high-quality randomized controlled trials of interventions and, therefore, the evidence is limited to single-center case series. |
format | Online Article Text |
id | pubmed-5708198 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-57081982017-12-08 Pelvic vein incompetence: clinical perspectives Riding, David M Hansrani, Vivak McCollum, Charles Vasc Health Risk Manag Review Chronic pelvic pain (CPP) affects 24% of premenopausal women, accounts for 20%–30% of UK gynecology outpatient appointments, and has an annual pan-European economic cost of €3.8 billion. Despite extensive investigation, often including laparoscopy, up to 55% of women do not receive a diagnosis and endure persistent symptoms. In these patients, clinical management focuses on symptom control rather than treatment. It is possible that pelvic vein incompetence (PVI) is a cause of CPP, although the quality of studies investigating an association is generally low. PVI may develop during and after pregnancy, as uterine blood flow increases significantly, pushing venous valve leaflets apart, and enabling retrograde venous flow. Analogies with varicose veins of the lower limb are helpful, and symptoms are similar. Women with symptomatic PVI report a dull pelvic ache that is worse on standing and sitting and persists throughout the day. It can be relieved by lying down. Early treatments for PVI included laparoscopic ligation; however, since the advent of endovascular occlusive techniques, treatments have lower risk and lower cost, and can be undertaken without sedation or anesthetic. However, there have been no high-quality randomized controlled trials of interventions and, therefore, the evidence is limited to single-center case series. Dove Medical Press 2017-11-27 /pmc/articles/PMC5708198/ /pubmed/29225469 http://dx.doi.org/10.2147/VHRM.S132827 Text en © 2017 Riding et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Review Riding, David M Hansrani, Vivak McCollum, Charles Pelvic vein incompetence: clinical perspectives |
title | Pelvic vein incompetence: clinical perspectives |
title_full | Pelvic vein incompetence: clinical perspectives |
title_fullStr | Pelvic vein incompetence: clinical perspectives |
title_full_unstemmed | Pelvic vein incompetence: clinical perspectives |
title_short | Pelvic vein incompetence: clinical perspectives |
title_sort | pelvic vein incompetence: clinical perspectives |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708198/ https://www.ncbi.nlm.nih.gov/pubmed/29225469 http://dx.doi.org/10.2147/VHRM.S132827 |
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