Pelvines Stauungssyndrom der Frau – ein Überblick

Mit dem heutigen pathophysiologischen und anatomischen Verständnis muss die Definition des pelvinen Stauungssyndroms weiter gefasst und in einen größeren Kontext gestellt werden. Dieser Beitrag versucht, die Beckenvenenstauung mit der Symptomatik des pelvinen Stauungssyndroms und der Pathophysiologie der venösen Insuffizienz der in die Beckenvenen drainierenden Ovarialvenen in Beziehung zu setzen. Mögliche Behandlungskonzepte werden beschrieben.

Abstract

The term “pelvic congestion syndrome” (PCS) in women dates back to the middle of the 19^th century. Until about 1950, the unclearly described and often diffuse lower abdominal complaints in women were attributed to psychosomatic phenomena. It was only in the second half of the 20^th century that the possible connection with chronic congestion of pelvic veins, mainly caused by reflux phenomena, was recognized. The current clinical definition of PCS (chronic, persistent pain in the small pelvis in women for at least 6 months) has led to more differentiated diagnostic and therapeutic considerations over the past 2 decades due to heightened awareness and modern diagnostic methods.

Clinically, dyspareunia, dysmenorrhea as well as vulvar and vaginal varices are among the typical complaints, often aggravated in an upright position. Pathophysiologically, pelvic congestion syndrome is a venous congestion caused by insufficient venous drainage. The venous plethora in the pelvis is often causally related to varicose veins of the legs. The ultrasound examination of the pelvic veins (transvaginal/transabdominal) cannot differentiate the morphological and functional changes (reflux and/or obstruction) in the pelvic area precisely enough. Therefore, before an interventional or surgical interruption of the pelvic reflux routes, a cross-sectional method, preferably a magnetic resonance imaging, is required for therapy planning. This paper attempts to link the symptoms of pelvic congestion syndrome to the pathophysiology of venous insufficiency of the pelvic veins. Particular attention is paid to the left ovarian vein. Possible treatment concepts are described.

Schlüsselwörter

pelvines Stauungssyndrom - chronische Beckenschmerzen - periphere Varizen - Beckenvenenreflux

Keywords

pelvic congestion syndrome - chronic pelvic pain - varicose veins - pelvic venous reflux - pelvic venous obstruction

Publikationsverlauf

Artikel online veröffentlicht:
14. August 2023

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