Pelvic vein incompetence and chronic pelvic pain: a case-control study

Vivak Hansrani; David M. Riding; Mourad Seif; Ann Caress; Katherine Payne; Jonathan Ghosh; Charles N. McCollum

doi:10.1111/1471-0528.17485

Pelvic vein incompetence and chronic pelvic pain: a case-control study

Vivak Hansrani, David M. Riding, Mourad Seif, Ann Caress, Katherine Payne, Jonathan Ghosh, Charles N. McCollum

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Objective: To investigate the association between chronic pelvic pain (CPP) and pelvic vein incompetence (PVI) or pelvic varices.

Design: Case–control study.

Setting: Gynaecology and vascular surgery services in two teaching hospitals in north-west England.

Sample: A total of 328 premenopausal women (aged 18–54 years), comprising 164 women with CPP and 164 matched controls with no history of CPP.

Methods: Symptom and quality-of-life questionnaires and transvaginal duplex ultrasound for PVI and pelvic varices.

Main outcome measures: Venous reflux of >0.7 s in the ovarian or internal iliac veins (primary outcome) and presence of pelvic varices (secondary outcome). Statistical analysis compared the prevalence of PVI between women with and without CPP using the two-sided chi-square test. Logistic regression was used to compare the odds of having PVI and pelvic varices between women with and without CPP.

Results: Pelvic vein incompetence was found on transvaginal duplex ultrasound in 101/162 (62%) women with CPP, compared with 30/164 (19%) asymptomatic controls (OR 6.79, 95% CI 4.11–11.47, p < 0.001). Forty-three of 164 (27%) women with CPP had pelvic varices compared with three of 164 (2%) asymptomatic women (OR 18.9, 95% CI 5.73–62.7, p < 0.001).

Conclusions: There was a significant association between PVI, as detected by transvaginal duplex imaging, and CPP. Pelvic varices were strongly associated with CPP and were infrequently seen in control patients. These results justify further evaluation of PVI and its treatment in well-designed research.

Original language	English
Pages (from-to)	1355-1361
Number of pages	7
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Volume	130
Issue number	11
Early online date	24 Apr 2023
DOIs	https://doi.org/10.1111/1471-0528.17485
Publication status	Published - 1 Oct 2023

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/1471-0528.17485Licence: CC BY

Cite this

@article{b860d732f5bc4019a426592bf001ef7b,

title = "Pelvic vein incompetence and chronic pelvic pain: a case-control study",

abstract = "Objective: To investigate the association between chronic pelvic pain (CPP) and pelvic vein incompetence (PVI) or pelvic varices. Design: Case–control study. Setting: Gynaecology and vascular surgery services in two teaching hospitals in north-west England. Sample: A total of 328 premenopausal women (aged 18–54 years), comprising 164 women with CPP and 164 matched controls with no history of CPP. Methods: Symptom and quality-of-life questionnaires and transvaginal duplex ultrasound for PVI and pelvic varices. Main outcome measures: Venous reflux of >0.7 s in the ovarian or internal iliac veins (primary outcome) and presence of pelvic varices (secondary outcome). Statistical analysis compared the prevalence of PVI between women with and without CPP using the two-sided chi-square test. Logistic regression was used to compare the odds of having PVI and pelvic varices between women with and without CPP. Results: Pelvic vein incompetence was found on transvaginal duplex ultrasound in 101/162 (62%) women with CPP, compared with 30/164 (19%) asymptomatic controls (OR 6.79, 95% CI 4.11–11.47, p < 0.001). Forty-three of 164 (27%) women with CPP had pelvic varices compared with three of 164 (2%) asymptomatic women (OR 18.9, 95% CI 5.73–62.7, p < 0.001). Conclusions: There was a significant association between PVI, as detected by transvaginal duplex imaging, and CPP. Pelvic varices were strongly associated with CPP and were infrequently seen in control patients. These results justify further evaluation of PVI and its treatment in well-designed research.",

keywords = "case-control study, chronic pelvic pain, pelvic venous incompetence, ultrasound, venous",

author = "Vivak Hansrani and Riding, {David M.} and Mourad Seif and Ann Caress and Katherine Payne and Jonathan Ghosh and McCollum, {Charles N.}",

note = "Funding Information: This research was funded by a Research for Patient Benefit project grant from the National Institute of Health Research (NIHR) (ref. PB‐PG‐0317‐20 040). Funding Information: The authors would like to acknowledge Katja Norse, Senior Clinical Vascular Scientist, in training and developing the necessary experience to deliver transvaginal duplex ultrasound for this study. Publisher Copyright: {\textcopyright} 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.",

year = "2023",

month = oct,

day = "1",

doi = "10.1111/1471-0528.17485",

language = "English",

volume = "130",

pages = "1355--1361",

journal = "BJOG: An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "Wiley-Blackwell",

number = "11",

}

TY - JOUR

T1 - Pelvic vein incompetence and chronic pelvic pain

T2 - a case-control study

AU - Hansrani, Vivak

AU - Riding, David M.

AU - Seif, Mourad

AU - Caress, Ann

AU - Payne, Katherine

AU - Ghosh, Jonathan

AU - McCollum, Charles N.

N1 - Funding Information: This research was funded by a Research for Patient Benefit project grant from the National Institute of Health Research (NIHR) (ref. PB‐PG‐0317‐20 040). Funding Information: The authors would like to acknowledge Katja Norse, Senior Clinical Vascular Scientist, in training and developing the necessary experience to deliver transvaginal duplex ultrasound for this study. Publisher Copyright: © 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

PY - 2023/10/1

Y1 - 2023/10/1

N2 - Objective: To investigate the association between chronic pelvic pain (CPP) and pelvic vein incompetence (PVI) or pelvic varices. Design: Case–control study. Setting: Gynaecology and vascular surgery services in two teaching hospitals in north-west England. Sample: A total of 328 premenopausal women (aged 18–54 years), comprising 164 women with CPP and 164 matched controls with no history of CPP. Methods: Symptom and quality-of-life questionnaires and transvaginal duplex ultrasound for PVI and pelvic varices. Main outcome measures: Venous reflux of >0.7 s in the ovarian or internal iliac veins (primary outcome) and presence of pelvic varices (secondary outcome). Statistical analysis compared the prevalence of PVI between women with and without CPP using the two-sided chi-square test. Logistic regression was used to compare the odds of having PVI and pelvic varices between women with and without CPP. Results: Pelvic vein incompetence was found on transvaginal duplex ultrasound in 101/162 (62%) women with CPP, compared with 30/164 (19%) asymptomatic controls (OR 6.79, 95% CI 4.11–11.47, p < 0.001). Forty-three of 164 (27%) women with CPP had pelvic varices compared with three of 164 (2%) asymptomatic women (OR 18.9, 95% CI 5.73–62.7, p < 0.001). Conclusions: There was a significant association between PVI, as detected by transvaginal duplex imaging, and CPP. Pelvic varices were strongly associated with CPP and were infrequently seen in control patients. These results justify further evaluation of PVI and its treatment in well-designed research.

AB - Objective: To investigate the association between chronic pelvic pain (CPP) and pelvic vein incompetence (PVI) or pelvic varices. Design: Case–control study. Setting: Gynaecology and vascular surgery services in two teaching hospitals in north-west England. Sample: A total of 328 premenopausal women (aged 18–54 years), comprising 164 women with CPP and 164 matched controls with no history of CPP. Methods: Symptom and quality-of-life questionnaires and transvaginal duplex ultrasound for PVI and pelvic varices. Main outcome measures: Venous reflux of >0.7 s in the ovarian or internal iliac veins (primary outcome) and presence of pelvic varices (secondary outcome). Statistical analysis compared the prevalence of PVI between women with and without CPP using the two-sided chi-square test. Logistic regression was used to compare the odds of having PVI and pelvic varices between women with and without CPP. Results: Pelvic vein incompetence was found on transvaginal duplex ultrasound in 101/162 (62%) women with CPP, compared with 30/164 (19%) asymptomatic controls (OR 6.79, 95% CI 4.11–11.47, p < 0.001). Forty-three of 164 (27%) women with CPP had pelvic varices compared with three of 164 (2%) asymptomatic women (OR 18.9, 95% CI 5.73–62.7, p < 0.001). Conclusions: There was a significant association between PVI, as detected by transvaginal duplex imaging, and CPP. Pelvic varices were strongly associated with CPP and were infrequently seen in control patients. These results justify further evaluation of PVI and its treatment in well-designed research.

KW - case-control study

KW - chronic pelvic pain

KW - pelvic venous incompetence

KW - ultrasound

KW - venous

UR - http://www.scopus.com/inward/record.url?scp=85153593992&partnerID=8YFLogxK

U2 - 10.1111/1471-0528.17485

DO - 10.1111/1471-0528.17485

M3 - Article

VL - 130

SP - 1355

EP - 1361

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 11

ER -

Pelvic vein incompetence and chronic pelvic pain: a case-control study

Abstract

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this