What is Pelvic Conjunction Syndrome?

USA After returning to work in the field of Interventional Radiology and Neuroradiology continued in our country Assoc. Dr. Başar Sarıkaya around the internal organs in the lower abdomen of the venous expansion and pressure increase means " Pelvic Conjunction Syndrome "Stated that it is a disease that is difficult to diagnose in society. Some of the women have this kind of abdomen ache the doctor visits the doctor because of the lack of diagnosis in many centers emphasized that they are inadequate. Sarikaya, some doctors, even if the diagnosis of this disease is serious about the lack of information on the treatment was stressed.

Just like headache, lower abdominal pain is common in the community, and about one third of women suffer from chronic lower abdominal pain at least once in their lifetime. Recent developments, particularly in the field of medical imaging, have shown that some of these pain may be due to "pelvic congestion syndrome".

Pelvic congestion syndrome is similar to varicose veins in the stomach, or varicocele in the testes around men. In other words, there is a problem in the operation of the veins in that area, and the blood flees backward as the heart needs to move towards the heart. We can compare the veins to the motorways in our bodies. Let's assume that a four-lane highway is the opposite of three lanes, so an endless traffic density, or "congestion," develops. In pelvic congestion syndrome, an abnormal pressure increase and enlargement occurs in the veins around the uterus, ovaries, and tubers, leading to chronic pain.

What are the characteristics of pain and other complaints in this disease?

The pain can be blunt and twitchy. It may be in the lower abdomen of the abdomen as well as in the belly and groin. In some cases only the town can be seen. In mens periods, after sexual intercourse, pregnancy The pain may become more pronounced at the end of a long and tiring day.

Other possible accompanying conditions include abnormal bleeding, burning during urination and frequent urination, vaginal discharge, or abdominal cramps that may accompany or varicose veins in the external genital area.

What is the frequency in society?

It is very, very difficult to give exact figures because the disease is often not correctly diagnosed. However, we know from statistics in the western countries, especially in USA, that chronic abdominal pain accounts for 10-15% of gynecological visits. There are studies showing that at least 30% of these patients have pelvic venous congestion as the main cause. So we can say that it is relatively frequent.

What are the risk factors?

Typically seen during the fertility period, that is, under 45 years. The presence of two or more pregnancy stories increases the risk. We know that pelvic congestion syndrome is very rare in a patient who has never been pregnant. Polycystic overgrowth, fullness in the limbs and other risks include edema and hormonal disorders.

How to diagnose?

Absolutely medical imaging is needed. In gynecological disorders, ultrasonography is usually the first method used. Ultrasonography is performed by most obstetricians in many centers and does not direct the patient to radiologists who are experts in this subject. This, unfortunately, leads to problems in diagnosis. It facilitates the detection of the presence of a number of special maneuvers during ultrasonography or repeated examinations in standing or sitting positions. Transvaginal ultrasonography may also provide better imaging in some cases.

Methods such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) can be used as problem solvers. Findings of pelvic venous congestion syndrome can be detected incidentally in some patients in these tests performed for other reasons.

What can be done in treatment?

The only definitive solution to the treatment can be obtained by embolization. The method of embolization is generally referred to as intra-vascular approach, feeding of vessels or organ, or interruption of blood flow. In embolization, the troubled region is reached through the veins and the blood flow of the troubled vein is prevented by various methods. This process can be accomplished successfully by interventional radiologists who have sufficient knowledge and experience in this area and who have completed advanced specialist training.

What is the success rate of treatment?

In 95% of cases, the problematic vessels are technically accessible during the procedure, and 85-90% of these patients benefit from the procedure.