Stratification of pelvic venous reflux in patients with pelvic varicose veins

Sg, Gavrilov; Moskalenko, Yekaterina P.; Mishakina, N.Yu.; Efremova, O.I.; Kulikov, V. M.; Grishenkova, A.S.

doi:10.1016/j.jvsv.2021.04.019

Cited by 20 publications

(15 citation statements)

References 35 publications

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“…In most women, the PeV status returns to normal, while in others the pelvic varicose veins persist and can constitute a basis for reflux development [ 19 , 20 ]. Subsequently, 60 to 76% of women with PeVD become symptomatic [ 4 , 21 , 22 , 23 , 24 ]. The reason for this phenomenon remains unclear [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Transvaginal duplex ultrasound (TVDUS) of the pelvic veins was performed using endovaginal micro-convex transducers with a frequency of 3–9 MHz and 3.5–10 MHz in the patient’s supine, half-sitting (with trunk raised to 45°) and half-standing positions [ 4 , 9 , 11 ]. The patency and diameter of the parametrial, uterine and gonadal veins (PVs, UVs and GVs, respectively) and IIV, as well as the presence and duration of reflux in these vessels were evaluated.…”

Section: Methodsmentioning

confidence: 99%

“…PVR was assessed using the previously developed classification, with types I (mild), II (moderate) and III (severe) PVR corresponding to the reflux duration of 1–2 s, 2.1–5 s and greater than 5 s (or with spontaneous reflux in PeVs without exercise load), accordingly [ 4 ].…”

Section: Methodsmentioning

confidence: 99%

“…The dilation of pelvic (parametrial, uterine and gonadal) veins and reflux in them are associated with the presence of chronic pelvic pain (CPP) in 60–76% of patients with pelvic venous disease (PeVD) [ 1 , 2 , 3 , 4 , 5 ]. According to the UIP consensus document, the dilation of pelvic veins (PeVs) is defined as an increase in their diameter of greater than 5 mm, and the pelvic venous reflux (PVR) is considered pathological if it lasts for greater than 1 s [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to the UIP consensus document, the dilation of pelvic veins (PeVs) is defined as an increase in their diameter of greater than 5 mm, and the pelvic venous reflux (PVR) is considered pathological if it lasts for greater than 1 s [ 2 ]. PVR of greater than 2 s in several pelvic venous collecting pools was found to be associated with severe CPP [ 4 ]. Some authors [ 6 ] also pointed out a relationship between the degree of PeV dilation and clinical manifestations of PeVD.…”

Section: Introductionmentioning

confidence: 99%

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Relationships of Pelvic Vein Diameter and Reflux with Clinical Manifestations of Pelvic Venous Disorder

Каралкин

Mishakina

et al. 2022

Diagnostics

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The causes of chronic pelvic pain (CPP) in patients with pelvic venous disorder (PeVD) are not completely understood. Various authors consider dilation of pelvic veins (PeVs) and pelvic venous reflux (PVR) as the main mechanisms underlying symptomatic forms of PeVD. The aim of this study was to assess relationships of pelvic vein dilation and PVR with clinical manifestations of PeVD. This non-randomized comparative cohort study included 80 female patients with PeVD who were allocated into two groups with symptomatic (n = 42) and asymptomatic (n = 38) forms of the disease. All patients underwent duplex scanning and single-photon emission computed tomography (SPECT) of PeVs with in vivo labeled red blood cells (RBCs). The PeV diameters, the presence, duration and pattern of PVR in the pelvic veins, as well as the coefficient of pelvic venous congestion (CPVC) were assessed. Two groups did not differ significantly in pelvic vein diameters (gonadal veins (GVs): 7.7 ± 1.3 vs. 8.5 ± 0.5 mm; parametrial veins (PVs): 9.8 ± 0.9 vs. 9.5 ± 0.9 mm; and uterine veins (UVs): 5.6 ± 0.2 vs. 5.5 ± 0.6 mm). Despite this, CPVC was significantly higher in symptomatic versus asymptomatic patients (1.9 ± 0.4 vs. 0.7 ± 0.2, respectively; p = 0.008). Symptomatic patients had type II or III PVR, while asymptomatic patients had type I PVR. The reflux duration was found to be significantly greater in symptomatic versus asymptomatic patients (median and interquartile range: 4.0 [3.0; 5.0] vs. 1.0 [0; 2.0] s for GVs, p = 0.008; 4.0 [3.0; 5.0] vs. 1.1 [1.0; 2.0] s for PVs, p = 0.007; and 2.0 [2.0; 3.0] vs. 1.0 [1.0; 2.0] s for UVs, p = 0.04). Linear correlation analysis revealed a strong positive relationship (Pearson’s r = 0.78; p = 0.007) of CPP with the PVR duration but not with vein diameter. The grade of PeV dilation may not be a determining factor in CPP development in patients with PeVD. The presence and duration of reflux in the pelvic veins were found to be predictors of the development of symptomatic PeVD.

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