Identification of Pelvic Congestion Syndrome Using Transvaginal Ultrasonography. A Useful Tool
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Data Collection
2.3. Ultrasound Assessment
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Variables | PCS Group | Normal Group | All Patients | p |
---|---|---|---|---|
Age | 41.5 ± 6.95 | 44.85 ± 9.92 | 42.2 ± 7.8 | 0.212 |
Multiparity | 29 (74.3%) | 11 (91.6%) | 40 (80%) | 0.197 |
Maximum newborn birth weight | 3565.56 ± 546.7 | 3665 ± 442.14 | 3591.9 ± 518.5 | 0.476 |
Menopausal | 3 (7.69%) | 3 (25%) | 6 (11.8%) | 0.165 |
Age of the on-set of symptoms | 31.5 ± 8.5 | 37.25 ± 12.7 | 32.96 ± 9.9 | 0.847 |
Worsening of symptoms during pregnancy | 27 (69.2%) | 5 (41.6%) | 32 (64%) | 0.119 |
Vulvar varicosities during pregnancy | 24 (61.5%) | 8 (66.6%) | 32 (64%) | 0.83 |
Medical history | 33 (84.6%) | 10 (83.3%) | 43 (84.3%) | 0.396 |
Endometriosis | 1 (2.5%) | 1 (8.3%) | 2 (3.9%) | 0.449 |
Adenomyosis | 1 (2.5%) | 2 (16.6%) | 3 (5.9%) | 0.156 |
Urologic disorders | 3 (7.69%) | 0 (0%) | 3 (5.9%) | 0.405 |
Gastrointestinal disorders | 0 (0%) | 1 (8.3%) | 1 (2%) | 0.255 |
Varicosities in lower extremities | 27 (69.2%) | 6 (50%) | 33 (64.7%) | 0.105 |
Prior pelvic surgery | 3 (7.9%) | 2 (16.6%) | 5 (9.8%) | 0.378 |
Fibroids | 4 (10.2%) | 3 (25%) | 7 (13.7%) | 0.256 |
Presence of varicosities (vulva, perineum, buttocks, lower extremities) | 29 (74.3%) | 7 (58.3%) | 36 (70.6%) | 0.14 |
Pain (VAS score ≥ 7) | ||||
Walking | 21 (53.8%) | 7 (58.3%) | 28 (56%) | 0.856 |
Sitting | 19 (48.7%) | 4 (33.3%) | 23 (46%) | 0.2 |
Supine | 15 (28.4%) | 5 (41.6%) | 20 (40%) | 0.895 |
Dysmenorrhea | 23 (58.9%) | 7 (58.3%) | 30 (60%) | 0.599 |
Dyspareunia | 16 (41%) | 4 (33.3%) | 20 (40%) | 0.43 |
Postcoital pain | 22 (56.5%) | 9 (75%) | 31 (62%) | 0.532 |
Lumbar pain | 13 (33.3%) | 4 (33.3%) | 17 (34%) | 0.775 |
Variables | PCS Group | Normal Group | All Patients | p |
---|---|---|---|---|
Uterine volume | 80 ± 30.8 | 73 ± 66.8 | 79.7 ± 41.4 | 0.626 |
Right ovarian volume | 9.94 ± 6.2 | 13.6 ± 13.1 | 10.65 ± 8 | 0.514 |
Left ovarian volume | 12.64 ± 8.5 | 15.2 ± 14.4 | 13.26 ± 9.9 | 0.5 |
PCO | 6 (15.8%) | 3 (23.1%) | 9 (17.6%) | 0.552 |
Largest pelvic vein Ø | 6.3 ± 4.5 | 4.8 ± 1.3 | 5.9 ± 2.8 | 0.308 |
Right side | 6.8 ± 12.4 | 3.9 ± 1.7 | 5.9 ± 10.5 | 0.411 |
Left side | 6.1 ± 3.2 | 4.7 ± 2.1 | 5.7 ± 2.9 | 0.187 |
Largest venous plexus Ø | 15.1 ± 6.4 | 12 ± 5.2 | 16.9 ± 12.1 | 0.009 |
Right side | 14.3 ± 7.9 | 10.5 ± 5.3 | 13.4 ± 7.4 | 0.185 |
Left side | 18.4 ± 13.1 | 9.5 ± 4.3 | 15.9 ± 12.03 | 0.155 |
Reverse of altered flow during Valsalva | 23 (58.9%) | 3 (25%) | 26 (51%) | 0.04 |
Crossing veins in the myometrium | 29 (74.35%) | 4 (33.3%) | 33 (64.7%) | 0.009 |
Crossing veins in the myometrium Ø | 3.5 ± 1.99 | 6 ± 4.2 | 3.75 ± 2.25 | 0.141 |
Pelvic vein Ø ≥ 8 mm | 36 (92.3%) | 3 (25%) | 39 (76.5%) | ˂0.000 |
Variables | Left Side | Right Side | p |
---|---|---|---|
Ovarian volume | 8 ± 15.4 | 7.4 ± 7.99 | 0.646 |
Largest pelvic vein Ø | 6 ± 3.6 | 4.5 ± 1.88 | 0.011 |
Largest venous plexus Ø | 15.2 ± 8.75 | 15.5 ± 9.75 | 0.359 |
Venography (Gold Standard) | |||||
---|---|---|---|---|---|
Normal | PCS | Total | p | ||
Transvaginal Ultrasound | Normal | 9 | 3 | 12 | ˂0.005 |
PCS | 3 | 36 | 39 | ||
Total | 12 | 39 | 51 |
Transvaginal Ultrasound | Value | CI 95% |
---|---|---|
Sensitivity | 92.31% | 78.03–97.99% |
Specificity | 75% | 42.84–93.31% |
Positive predictive value | 92.28% | 81.71–96.97% |
Negative predictive value | 75.07% | 49.18–90.36% |
False positive rate | 7.69% | 2.01–21.97% |
False negative rate | 25% | 6.7–57.16% |
Transvaginal Ultrasound | Nulliparous | Multiparous | p |
---|---|---|---|
Largest pelvic vein Ø | 5.6 ± 2.3 | 6.2 ± 2.9 | 0.25 |
Largest venous plexus Ø | 16 ± 4.55 | 17.2 ± 12.6 | 0.75 |
Premenopause | Menopause | p | |
Largest pelvic vein Ø | 6.2 ± 2.8 | 4.9 ± 2.1 | 0.43 |
Largest venous plexus Ø | 16 ± 7.3 | 27.5 ± 35.2 | 0.33 |
No adenomyosis | Adenomyosis | p | |
Largest pelvic vein Ø | 5.8 ± 2.8 | 6.9 ± 0.21 | 0.33 |
Largest venous plexus Ø | 15.9 ± 11.6 | - | - |
No fibroids | Fibroids | p | |
Largest pelvic vein Ø | 6.1 ± 2.9 | 6.2 ± 0.61 | 0.7 |
Largest venous plexus Ø | 17.1 ± 12.4 | 16.5 ± 5.7 | 0.17 |
Normal ovaries | PCO | p | |
Largest pelvic vein Ø | 6.11 ± 2.9 | 6.2 ± 1.8 | 0.44 |
Largest venous plexus Ø | 17.7 ± 12.8 | 14 ± 4.8 | 0.98 |
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Valero, I.; Garcia-Jimenez, R.; Valdevieso, P.; Garcia-Mejido, J.A.; Gonzalez-Herráez, J.V.; Pelayo-Delgado, I.; Fernandez-Palacin, A.; Sainz-Bueno, J.A. Identification of Pelvic Congestion Syndrome Using Transvaginal Ultrasonography. A Useful Tool. Tomography 2022, 8, 89-99. https://doi.org/10.3390/tomography8010008
Valero I, Garcia-Jimenez R, Valdevieso P, Garcia-Mejido JA, Gonzalez-Herráez JV, Pelayo-Delgado I, Fernandez-Palacin A, Sainz-Bueno JA. Identification of Pelvic Congestion Syndrome Using Transvaginal Ultrasonography. A Useful Tool. Tomography. 2022; 8(1):89-99. https://doi.org/10.3390/tomography8010008
Chicago/Turabian StyleValero, Irene, Rocio Garcia-Jimenez, Pamela Valdevieso, Jose A. Garcia-Mejido, Jose V. Gonzalez-Herráez, Irene Pelayo-Delgado, Ana Fernandez-Palacin, and Jose A. Sainz-Bueno. 2022. "Identification of Pelvic Congestion Syndrome Using Transvaginal Ultrasonography. A Useful Tool" Tomography 8, no. 1: 89-99. https://doi.org/10.3390/tomography8010008
APA StyleValero, I., Garcia-Jimenez, R., Valdevieso, P., Garcia-Mejido, J. A., Gonzalez-Herráez, J. V., Pelayo-Delgado, I., Fernandez-Palacin, A., & Sainz-Bueno, J. A. (2022). Identification of Pelvic Congestion Syndrome Using Transvaginal Ultrasonography. A Useful Tool. Tomography, 8(1), 89-99. https://doi.org/10.3390/tomography8010008