Dr Eisen Liang speaks on Pelvic Congestion Syndrome
23-Sep-2015 On 7th September 2015, Dr Liang spoke to the SAN gynaecologists on Pelvic Congestion Syndrome: Diagnosis and Treatment with Ovarian Vein Embolistion. He will speak again at the the upcoming 2015 Symposium of the Australasian Sonographers Association on 19th September 2015.
Pelvic Congestion Syndrome is an under-recognised, under-diagnosed and potentially mismanaged condition. There is a long list of differential diagnosis of pelvic pain in women. Typically the pain from pelvic congestion is described as dull ache in the lower abdominal, that might radiate to the groins and the back. The onset of pain is often towards the end of a long day in upright position, standing or sitting, or after exercise especially weight lifting. There could be pain during and after sexual intercourse. The patients are often singers, dancers, gym instructors, teachers and shopkeepers. The women are often multiparous, with history of valval or leg varicose veins. Transvaginal sonography can demonstrate dilated parametrial and adnexal veins that enlarge with valsalva and bloom with colour flow. With ideal body habitus, reflux in the ovarian vein can be demonstrated at renal hilum and loin region. Left ovarian vein reflux is far more common than the right. Reflux in the internal iliac vein tributaries can constitute pelvic congestion but these might be difficult to demonstrate with transabdomenal duplex study. The definitive evaluation is by catheter venogram, performed on a tilting angiographic table with patient performing valsalva. When refluxing veins were found, they can be embolised with coils and fibrovein foam.