Pelvic Congestion Syndrome: Difference between revisions
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<div class="noeditbox">Welcome to [[Pathophysiology of Complex Patient Problems|PT 635 Pathophysiology of Complex Patient Problems]] This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div><div class="editorbox"> | | ||
<div class="noeditbox">Welcome to [[Pathophysiology of Complex Patient Problems|PT 635 Pathophysiology of Complex Patient Problems]] This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div><div class="editorbox"> | |||
'''Original Editors '''- [[Pathophysiology of Complex Patient Problems|Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.]] | '''Original Editors '''- [[Pathophysiology of Complex Patient Problems|Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.]] | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | ||
</div> | </div> | ||
== Definition/Description == | == Definition/Description == | ||
A manifestation of Peripheral Vascular Disease (PVD) in ovarian veins which causes the blood to flow backwards instead of forward, or up, towards the heart (1). "Vericose Veins of the ovaries" (1). This syndrome has various names such as ovarian variocele or ovarian varicocele (1). | A manifestation of Peripheral Vascular Disease (PVD) in ovarian veins which causes the blood to flow backwards instead of forward, or up, towards the heart (1). "Vericose Veins of the ovaries" (1). This syndrome has various names such as ovarian variocele or ovarian varicocele (1). | ||
== Prevalence == | == Prevalence == | ||
Most often seen in women who are of childbearing age, or older (1). Majority of women who are affected have had a history of multiple pregnancies (1). This syndrome can also occur in men and is diagnosed through presentation of visible varicosities on the scrotum (1). Is the cause of about 10-15% of referrals to gynecologists or other pain related clinics (4).<br> | Most often seen in women who are of childbearing age, or older (1). Majority of women who are affected have had a history of multiple pregnancies (1). This syndrome can also occur in men and is diagnosed through presentation of visible varicosities on the scrotum (1). Is the cause of about 10-15% of referrals to gynecologists or other pain related clinics (4).<br> | ||
'''Characteristics/Clinical Presentation ''' | '''Characteristics/Clinical Presentation ''' | ||
Pelvic Congestion Syndrome may be asymptomatic and often times may go undiagnosed (4). Can cause continuous or intermittent lower abdominal or pelvic pain, ranging from a dull ache to a sharp severe pain (1). Duration of pain can last more than 6 months (2). The lower abdominal, or pelvic, pain associated with PCS can be felt unilaterally,on one side, or bilaterally, occurring on both left and right sides of the body (1). The pain usually is worse by the end of the day, with long periods of standing, or related to the onset of mensus (1,2). | Pelvic Congestion Syndrome may be asymptomatic and often times may go undiagnosed (4). Can cause continuous or intermittent lower abdominal or pelvic pain, ranging from a dull ache to a sharp severe pain (1). Duration of pain can last more than 6 months (2). The lower abdominal, or pelvic, pain associated with PCS can be felt unilaterally,on one side, or bilaterally, occurring on both left and right sides of the body (1). The pain usually is worse by the end of the day, with long periods of standing, or related to the onset of mensus (1,2). | ||
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Other common clinical presentations, noted in Goodman (1), associated with PCS include: | Other common clinical presentations, noted in Goodman (1), associated with PCS include: | ||
*Tenderness upon deep palapation of the ovarian point | *Tenderness upon deep palapation of the ovarian point | ||
*Dyspareunia | *Dyspareunia | ||
*Presence of varicose veins in the buttock and/or lower extremities | *Presence of varicose veins in the buttock and/or lower extremities | ||
*Headache | *Headache | ||
*Gastrointestinal pain/discomfort | *Gastrointestinal pain/discomfort | ||
*Changes in bowel and bladder | *Changes in bowel and bladder | ||
*Fatigue | *Fatigue | ||
*Insomnia | *Insomnia | ||
*Heaviness feeling felt in the lower abdomen or pelvic region | *Heaviness feeling felt in the lower abdomen or pelvic region | ||
*Lower back pain worsened upon standing upright | *Lower back pain worsened upon standing upright | ||
<br> | |||
Ignacio et al. (2) also found other associated signs and symptoms related to PCS including: | Ignacio et al. (2) also found other associated signs and symptoms related to PCS including: | ||
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== Associated Co-morbidities == | == Associated Co-morbidities == | ||
Impaired circulatory function, such as peripheral vascular disease, is often associated with PCS (1).<br> | Impaired circulatory function, such as peripheral vascular disease, is often associated with PCS (1).<br> | ||
== Medications == | == Medications == | ||
Patients with PCS can often be prescribed hormonal medications (4). This pharmacological management of this condition is directed towards decreasing congestion from the varicose veins, and also decreasing blood flow to the varicose veins (5). | Patients with PCS can often be prescribed hormonal medications (4). This pharmacological management of this condition is directed towards decreasing congestion from the varicose veins, and also decreasing blood flow to the varicose veins (5). | ||
== Diagnostic Tests/Lab Tests/Lab Values == | == Diagnostic Tests/Lab Tests/Lab Values == | ||
add text here <br> | add text here <br> | ||
== Etiology/Causes == | == Etiology/Causes == | ||
add text here <br> | add text here <br> | ||
== Systemic Involvement == | == Systemic Involvement == | ||
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== Differential Diagnosis == | == Differential Diagnosis == | ||
Due to clinical presentation, PCS has an extensive list of differential diagnosis to be ruled out prior to the diagnosis. Ignacio et al. has suggested the following differential diagnosis list: | Due to clinical presentation, PCS has an extensive list of differential diagnosis to be ruled out prior to the diagnosis. Ignacio et al. has suggested the following differential diagnosis list: | ||
*Bowel Pathology | *Bowel Pathology | ||
*Cancer | *Cancer | ||
*Endometriosis | *Endometriosis | ||
*Fibroids | *Fibroids | ||
*Fibromyalgia | *Fibromyalgia | ||
*Ovarian Cyst | *Ovarian Cyst | ||
*Pelvic Inflammatory Disorder | *Pelvic Inflammatory Disorder | ||
*Porphyria | *Porphyria | ||
*Uterine Prolapse | *Uterine Prolapse | ||
*Orthopedic, Neurologic, or Urogenic Pathology (2) | *Orthopedic, Neurologic, or Urogenic Pathology (2) | ||
<br> | |||
In addition to some characteristics above, Semmel also suggested the remaining differential diagnosis: | |||
*Leiomyoma | |||
*Adenomyosis | |||
*Leiomyoma | *Nutcracker Syndrome | ||
*Adenomyosis | *Inflammatory Bowel Syndrome | ||
*Nutcracker Syndrome | *Diverticulitis/Diverticulosis/Meckel's Diverticulum | ||
*Inflammatory Bowel Syndrome | *Interstitial Cystitis<br> | ||
*Diverticulitis/Diverticulosis/Meckel's Diverticulum | *Fascitis | ||
*Interstitial Cystitis<br> | *Psychosexual Dysfunction | ||
*Fascitis | |||
*Psychosexual Dysfunction | |||
*Depression (6). | *Depression (6). | ||
== Case Reports/ Case Studies == | == Case Reports/ Case Studies == | ||
add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | add links to case studies here (case studies should be added on new pages using the [[Template:Case Study|case study template]])<br> | ||
== Resources <br> == | == Resources <br> == | ||
add appropriate resources here | add appropriate resources here | ||
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<div class="researchbox"> | <div class="researchbox"> | ||
<rss>addfeedhere|charset=UTF-8|short|max=10</rss> | <rss>addfeedhere|charset=UTF-8|short|max=10</rss> | ||
</div> | </div> | ||
== References == | == References == | ||
see [[Adding References|adding references tutorial]]. | see [[Adding References|adding references tutorial]]. | ||
<references /> | <references /> | ||
[[Category:Bellarmine_Student_Project]] | [[Category:Bellarmine_Student_Project]] | ||
Revision as of 01:09, 5 April 2016
Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Megan Petty, Cynthia Brown, WikiSysop, Kim Jackson, Nicole Hills, Lucinda hampton and Elaine Lonnemann
Definition/Description[edit | edit source]
A manifestation of Peripheral Vascular Disease (PVD) in ovarian veins which causes the blood to flow backwards instead of forward, or up, towards the heart (1). "Vericose Veins of the ovaries" (1). This syndrome has various names such as ovarian variocele or ovarian varicocele (1).
Prevalence[edit | edit source]
Most often seen in women who are of childbearing age, or older (1). Majority of women who are affected have had a history of multiple pregnancies (1). This syndrome can also occur in men and is diagnosed through presentation of visible varicosities on the scrotum (1). Is the cause of about 10-15% of referrals to gynecologists or other pain related clinics (4).
Characteristics/Clinical Presentation
Pelvic Congestion Syndrome may be asymptomatic and often times may go undiagnosed (4). Can cause continuous or intermittent lower abdominal or pelvic pain, ranging from a dull ache to a sharp severe pain (1). Duration of pain can last more than 6 months (2). The lower abdominal, or pelvic, pain associated with PCS can be felt unilaterally,on one side, or bilaterally, occurring on both left and right sides of the body (1). The pain usually is worse by the end of the day, with long periods of standing, or related to the onset of mensus (1,2).
Other common clinical presentations, noted in Goodman (1), associated with PCS include:
- Tenderness upon deep palapation of the ovarian point
- Dyspareunia
- Presence of varicose veins in the buttock and/or lower extremities
- Headache
- Gastrointestinal pain/discomfort
- Changes in bowel and bladder
- Fatigue
- Insomnia
- Heaviness feeling felt in the lower abdomen or pelvic region
- Lower back pain worsened upon standing upright
Ignacio et al. (2) also found other associated signs and symptoms related to PCS including:
- Increased pain at the end of the day
- Pain increased upon sitting and/or standing
- Lethargy
- Depression
- Vaginal discharge
- Dysmenorrhea
- Swollen vulva
- Lumbosacral neuropathy
- Rectal discomfort
Associated Co-morbidities[edit | edit source]
Impaired circulatory function, such as peripheral vascular disease, is often associated with PCS (1).
Medications[edit | edit source]
Patients with PCS can often be prescribed hormonal medications (4). This pharmacological management of this condition is directed towards decreasing congestion from the varicose veins, and also decreasing blood flow to the varicose veins (5).
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
add text here
Etiology/Causes[edit | edit source]
add text here
Systemic Involvement[edit | edit source]
add text here
Medical Management (current best evidence)[edit | edit source]
add text here
Physical Therapy Management (current best evidence)[edit | edit source]
add text here
Differential Diagnosis[edit | edit source]
Due to clinical presentation, PCS has an extensive list of differential diagnosis to be ruled out prior to the diagnosis. Ignacio et al. has suggested the following differential diagnosis list:
- Bowel Pathology
- Cancer
- Endometriosis
- Fibroids
- Fibromyalgia
- Ovarian Cyst
- Pelvic Inflammatory Disorder
- Porphyria
- Uterine Prolapse
- Orthopedic, Neurologic, or Urogenic Pathology (2)
In addition to some characteristics above, Semmel also suggested the remaining differential diagnosis:
- Leiomyoma
- Adenomyosis
- Nutcracker Syndrome
- Inflammatory Bowel Syndrome
- Diverticulitis/Diverticulosis/Meckel's Diverticulum
- Interstitial Cystitis
- Fascitis
- Psychosexual Dysfunction
- Depression (6).
Case Reports/ Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Extension:RSS -- Error: Not a valid URL: addfeedhere|charset=UTF-8|short|max=10
References[edit | edit source]
see adding references tutorial.
