Quantify the Degree of Pain Relief of Pelvic Congestion Syndrome Following Gonadal Vein Embolization

Chronic pelvic pain affects almost 40% of women during their lifetime. Pelvic congestion
syndrome (PCS) accounts for up to 30% of those with chronic pelvic pain. The most common
underlying cause of PCS is incompetence or obstruction of the gonadal veins, resulting in
painful congestion of the pelvic and perineal venous vasculature. Medical treatment is first
line, and aims to suppress ovarian function and induce vasoconstriction of the venous system.
Unfortunately, efficacy and long-term pain relief from medical therapy is limited. Coil
embolization of the gonadal veins has been shown to decrease pain in those affected by PCS,
although the degree of relief has not yet been quantified.

Inclusion Criteria:

- Female patients 18 years of age or older

- Meet the clinical and imaging criteria for the diagnosis of PCS and have no
contraindications to coil embolization of the gonadal veins.

- Patients who are treated with coil embolization of the gonadal veins in the
Interventional Radiology division between October 1, 2018 to October 1, 2019.

Exclusion Criteria:

- Patients less than 18 years of age.

- Patients who are found to have an underlying cause of pelvic congestion syndrome
unrelated to venous congestion and insufficiency. This includes, but is not limited
to, nutcracker syndrome, or a mass resulting in extrinsic compression of the gonadal
veins.

- Patients who have received prior surgical therapy for PCS, including bilateral
salpingo-oophorectomy (TAH-BSO), gonadal vein resection, or gonadal vein ligation.