What is it about?

This article was an invited commentary on pelvic congestion syndrome (PCS). Previously I had suggested that there could be a way of grading PCS on duplex ultrasound. Sergey Gavrilov produced a paper showing the pattern of duplex ultrasound findings in PCS. This invited commentary on that paper suggested that now we can see the pattern of pelvic reflux on ultrasound in PCS, this should become a primary diagnosis rather than doctors checking every other cause of pelvic pain first.

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Why is it important?

Pelvic congestion syndrome (PCS) is the cause of chronic pelvic pain (CPP) in approximately one third (30%) of women going to gynaecology out-patients. Despite this, most gynaecologists still do not diagnose PCS - and usually tell patients that they have endometriosis or that there is nothing wrong that can be found. Many women only get their diagnosis of PCS and get treatment after years of looking for help. This publication suggests that as PCS can be diagnosed so easily with the Transvaginal Ultrasound using the Holdstock-Harrison protocol, it should be the first thing looked for and diagnosed if present.


With PCS being one of the most common causes of pelvic pain, it is incredible that so many women still do not get diagnosed nor offered treatment. This is yet another publication from The Whiteley Clinic highlighting PCS, and helping doctors and patients to think of PCS as a possible diagnosis so it is not missed. Indeed, as it is so common, and so easily diagnosed and treated compared to other causes of pelvic pain, it should be one of the first conditions looked for in such patients.

Professor Mark S Whiteley
The Whiteley Clinic

Read the Original

This page is a summary of: Pelvic venous pain due to pelvic congestion syndrome is becoming a primary diagnosis, Journal of Vascular Surgery Venous and Lymphatic Disorders, November 2021, Elsevier,
DOI: 10.1016/j.jvsv.2021.05.003.
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