The impact of pelvic venous congestion on chronic pelvic pain

• Research type

  Research Study

• Full title

  The impact of pelvic venous congestion on chronic pelvic pain

• IRAS ID

  277050

• Contact name

  Thulasi Setty

• Contact email

  Thulasi.setty@nhs.net

• Sponsor organisation

  University College London

• Clinicaltrials.gov Identifier

  Z6364106/2020/07/107 , UCL Data Protection

• Duration of Study in the UK

  1 years, 1 months, 0 days

• Research summary

  Chronic pelvic pain (CPP), described as pain in the lower abdomen or pelvis for more than six months, affects up to 1 in 6 women. Despite ultrasound scans or key hole surgery, the cause of pain in approximately 30%-50% of patients remains unexplained.

  Pelvic venous congestion (the presence of varicose veins in the pelvis) has the potential to cause chronic pain. Potentially, up to 30% of patients presenting with CPP have pelvic varicose veins as the sole cause. Symptoms include: pain after prolonged standing/walking relieved on lying down; pain after intercourse or unilateral dull ache.

  Pelvic varicose veins result from failing venous valves after pregnancy or due to the effect of hormones such as oestrogen. Over time, veins enlarge due to pooling of blood; the pressure of engorged veins on surrounding organs such as ovaries, womb and bladder cause pain.

  Pelvic varicose veins associated with CPP is known as Pelvic Congestion Syndrome (PCS). Not all patients found to have pelvic varicose veins, however, have pain. PCS remains a poorly understood cause of CPP amongst gynaecologists and is not commonly investigated for. We would like to have a better understanding of the effect of pelvic varicose veins on patients’ pain and quality of life.

  Patients attending our gynaecology clinic will be invited to join our study. They will be asked to complete a questionnaire on their symptoms and quality of life and undergo a transvaginal ultrasound scan (as per routine care) which is slightly longer in duration for a detailed assessment of gynaecological organs and pelvic vessels. This will be beneficial in helping us understand the correlation between abnormal pelvic venous diameters and blood flow with pain. 

  The questionnaire and longer ultrasound scan will take a few extra minutes of patients’ time. If diagnosed with PCS patients will be offered established treatments.

• REC name

  East Midlands - Leicester Central Research Ethics Committee

• REC reference

  20/EM/0277

• Date of REC Opinion

  12 Nov 2020

• REC opinion

  Favourable Opinion