Duplex ultrasound in patients with pelvic congestion syndrome in comparison to conventional venography

Abstract Background Chronic pelvic pain is defined by the American College of Obstetricians and Gynaecologists as chronic pain originates from the pelvic organs typically lasting more than 6 months caused by dilatation of the ovarian and/or pelvic veins (Hagag et al. in Egypt J Surg 41(3):1334–1344, 2022). Results Transabdominal and transvaginal duplex and leak points assessment ultrasonography were performed to fifty female patients with pelvic venous congestion symptoms referred by their physicians. Results were compared with conventional venography. It showed that transvaginal ultrasound (TVUS) was highly concordant with the conventional method, while Transabdominal ultrasound (TAUS) was less concordant with the conventional method, especially for the left side. As regards assessing the reflux of the right ovarian vein. The sensitivity of the test is 92.31%, and the specificity was 97.3%, indicating high diagnostic power of TVUS. As for detecting left ovarian vein reflux showed sensitivity (97.44%) and specificity (81.82%). Excellent diagnostic performance of assessing reflux of right internal iliac vein (IIV) with sensitivity and specificity 100%. The sensitivity was 100% and specificity was 97.22%, with outstanding diagnostic performance in assessing the reflux of left IIV. The sensitivity was 100% and specificity was 90.63%, indicating excellent diagnostic performance of US for perineal leak 88.89% and 92.68% for inguinal leak, 66.67% and 95.74% for gluteal leak, and 40% and 100% for obturator leak point. Conclusion TVUS is a very useful noninvasive diagnostic tool in treatment of pelvic venous congestion, with a very beneficial complementary TAUS, and assessment of pelvic leak points. Limitations in our study in patient preparation were compliance and operative machine quality.