Does pelvic congestion cause bladder symptoms-potential new indication to treat pelvic congestion

Abstract

BACKGROUND: Pelvic Congestion Syndrome (PCS) is a condition characterised by chronic pelvic pain resulting from the dilation and reflux of veins within the pelvis. While pelvic pain is the primary symptom of PCS, other associated symptoms may vary among individuals. Bladder symptoms have been commonly observed in PCS, including increased urination frequency, urinary urgency, nocturia and rarely haematuria. This study aimed to investigate the prevalence of bladder symptoms in women with pelvic congestion syndrome and the effectiveness of Ovarian Vein Embolisation in alleviating these symptoms. METHODS: This was a retrospective cohort study on women diagnosed with PCS between January 1, 2017, and December 31, 2022. Inclusion criteria were defined as the presence of clinical symptoms and radiological evidence of PCS undergoing Ovarian Vein Embolisation (OVE). Participants were followed up at least 6 months post-procedure using a web-based survey to assess their bladder symptoms. RESULTS: One hundred and twenty-three women underwent OVE for PCS during the study period and consented to participate in the study, and 65% (n = 80) reported experiencing bladder symptoms. The most common bladder symptoms during pre-procedure consultations included daytime frequency, a sense of incomplete emptying, and nocturia. Among the individuals with bladder symptoms, 60/80 (75%) reported symptom improvement following OVE. Furthermore, 11/80 patients (13.8%) noted a complete resolution of their symptoms post-OVE, and 30/80 patients (37.5%) reported significant improvement. There were no reported major complications or mortality following OVE. CONCLUSIONS: The findings of this study provided compelling evidence that bladder symptoms are common in women with PCS. Ovarian Vein Embolization emerges as a safe and effective intervention for alleviating concurrent bladder symptoms in these patients.