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Андрология и генитальная хирургия. 2020; 21: 31-39

Синдром тазовой конгестии и проблемы репродукции: междисциплинарный подход

Сулима А. Н., Жуков О. Б., Рыбалка А. Н.

https://doi.org/10.17650/2070-9781-2020-21-4-31-39

Аннотация

Обзор посвящен анализу научных данных об одном из малоизвестных и недостаточно изученных клинических синдромов – синдрому тазовой конгестии. На основании анализа иностранных и отечественных источников выделены наиболее вероятные анатомические, гормональные и иные причины развития данного синдрома. Предпринята попытка объяснить патогенетические механизмы, приводящие к нарушению репродуктивной функции у пациенток с синдромом тазовой конгестии.

Список литературы

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4. MacDonald S.R., Klock S.C., Milad M.P. Long-term outcome of nonconservative surgery (hysterectomy) for endometriosis-associated pain in women <30 years old. Am J Obst Gynecol 1999;180(6):1360–3. DOI: 10.1016/s0002-9378(99)70020-7.

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6. Ignacio E.A., Dua R., Sarin S. et al. Pelvic congestion syndrome: diagnosis and treatment. Semin Intervent Radiol 2008;25:361–8. DOI: 10.1055/s-0028-1102998.

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8. Bergan J. The vein book. Oxford University Press, 2007. Pp. 315–321. DOI: 10.1016/b978-012369515-4/50003-x.

9. Cheong Y., William S. Chronic pelvic pain: aetiology and therapy. Best Pract Res Clin Obstet Gynaecol 2006;20:695–711. DOI: 10.1016/j.bpobgyn.2006.04.004.

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16. Latthe P., Mignini L., Gray R. et al. Factors predisposing women to chronic pelvic pain: systematic review. BMJ 2006;332(7544):749–5. DOI: 10.1136/bmj.38748.697465.55.

17. Moore J., Kennedy S. Causes of chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol 2000;14(3): 389–402. DOI: 10.1053/beog.1999.0082.

18. Nasser F., Cavalcante R.N., Affonso B.B. et al. Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome. Int J Gynecol Obstet 2014;125(1):65–8. DOI: 10.1016/j.ijgo.2013.10.008.

19. Beard R.W., Highman J.H., Pearce S., Reginald P.W. Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet 1984;2(8409):946–9. DOI: 10.1016/s0140-6736(84)91165-6.

20. Beard R., Reginald P., Wadsworth J. Сlinical features of women with chronic lower abdominal pain and pelvic congestion. Br J Obstet Gynaecol 1988;95(2):153–61. DOI: 10.1111/j.1471-0528.1988.tb06845.x.

21. Foong L.C., Gamble J., Sutherland I.A., Beard R.W. Altered peripheral vascular response of women with and without pelvic pain due to congestion. BJOG 2000;107(2):157–64. DOI: 10.1111/j.1471-0528.2000.tb11684.x.

22. Punab M., Poolamets O., Paju P. et al. Causes of male infertility: a 9-year prospective monocentre study on 1737 patients with reduced total sperm counts. Hum Reprod 2017;32(1):18–31. DOI: 10.1093/humrep/dew284.

23. Zucker E.J., Ganguli S., Ghoshhajra B.B. et al. Imaging of venous compression syndromes. Cardiovasc Diagn Ther 2016;6(6):519–32. DOI: 10.21037/cdt.2016.11.19.

24. Steenbeek M.P., van der Vleuten C.J.M., Schultze Kool L.J., Nieboer T.E. Noninvasive diagnostic tools for pelvic congestion syndrome: a systematic review. Acta Obstet Gynecol Scand 2018;97(7): 776–86. DOI: 10.1111/aogs.13311.

25. Halligan S., Campbell D., Bartram C.I. et al. Transvaginal ultrasound examination of women with and without pelvic venous congestion. Clin Radiol 2000;55:954–8. DOI: 10.1053/crad.2000.0602.

26. Park S.J., Lim J.W., Ko Y.T. et al. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. Am J Roentgenol 2004;182: 683–8. DOI: 10.2214/ajr.182.3.1820683.

27. Giacchetto G., Cotroneo G.B., Marincolo F. et al. Ovarian varicocele: ultrasonic and phlebographic evaluation. J Clin Ultrasound 1990;18:551–5. DOI: 10.1002/jcu.1870180705.

28. Hudson-Dixon C.M., Long B.W., Cox L.A. Power Doppler imaging: principles and Applications. Radiol Technol 1999;70:235–43.

29. Campbell D., Halligan S., Bartram C.I. et al. Transvaginal power Doppler ultrasound in pelvic congestion. Acta Radiol 2003;44:269–74. DOI: 10.1080/j.1600-0455.2003.00063.x.

30. Malgor R.D., Adrahtas D., Spentzouris G. et al. The role of duplex ultrasound in the workup of pelvic congestion syndrome. J Vasc Surg Venous Lymphat Disord 2014;2:34–8. DOI: 10.1080/j.1600-0455.2003.00063.x.

31. Yang D.M., Kim H.C., Nam D.H. et al. Time-resolved MR angiography for detecting and grading ovarian venous reflux: comparison with conventional venography. Br J Radiol 2012;1014:117–22. DOI: 10.1259/bjr/79155839.

32. Asciutto G., Mumme A., Marpe B. et al. MR venography in the detection of pelvic venous congestion. Eur J Vasc Endovasc Surg 2008;36:491–6. DOI: 10.1016/j.ejvs.2008.06.024.

33. Rozenblit A.M., Ricci Z.J., Tuvia J., Amis E.S. Jr. Incompetent and dilated ovarian veins: a common CT finding in asymptomatic parous women. Am J Roentgenol 2001;176:119–22. DOI: 10.1016/j.ejvs.2008.06.024.

34. Неймарк А.И., Шелковникова Н.В. Эндоваскулярное лечение стойкой дизурии и хронических тазовых болей при варикозном расширении вен малого таза у женщин. Урология 2012;(4):20–4.

35. Kies D.D., Kim H.S. Pelvic congestion syndrome: a review of current diagnostic and minimally invasive treatment modalities. Phlebol Venous Forum R Soc Med 2012;27:52–7. DOI: 10.1258/phleb.2012.012s27.

36. Infertility definitions and terminology (WHO). Available at: https://www.who.int/reproductivehealth/topics/infertility/definitions/en.

37. Приказ Минздрава России от 30 августа 2012 г. № 107н «О порядке использования вспомогательных репродуктивных технологиях, противопоказаниях и ограничениях к их применению». Доступно по: https://www.rosminzdrav.ru/documents/8023-prikaz-o-poryadke-ispolzovaniya-vspomogatelnyh-reproduktivnyh-tehnologiy-protivopokazaniyah-i-ogranicheniyah-k-ih-primeneniyu.

38. Пост-релиз VII Международный конгресс «Оргздрав 2019», 24–25 апреля 2019, Москва. Доступно по: https://www.vshouz.ru/orgzdrav2019/.

Andrology and Genital Surgery. 2020; 21: 31-39

Pelvic congestion syndrome and reproductive problems: an interdisciplinary approach

Sulima A. N., Zhukov О. B., Rybalka A. N.

https://doi.org/10.17650/2070-9781-2020-21-4-31-39

Abstract

The review is devoted to one of the unknown, debatable and completely unexplored clinical syndromes –pelvic congestion syndrome. Based on the study of foreign and domestic literature, the probable anatomical, hormonal and other causes of the development of this syndrome were analyzed. An attempt was made to explain and understand the pathogenetic mechanisms leading to impaired reproductive function in this category of patients.

References

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8. Bergan J. The vein book. Oxford University Press, 2007. Pp. 315–321. DOI: 10.1016/b978-012369515-4/50003-x.

9. Cheong Y., William S. Chronic pelvic pain: aetiology and therapy. Best Pract Res Clin Obstet Gynaecol 2006;20:695–711. DOI: 10.1016/j.bpobgyn.2006.04.004.

10. Koc Z., Ulusan S., Oguzkurt L. Right ovarian vein variant: is there a relationship with varices? Eur J Radiol 2006;59:465–71. DOI: 10.1016/j.ejrad.2006.03.021.

11. Govil S., Justus A. Using the ovarian vein to find the ovary. Abdom Imaging 2006;31:747–50. DOI: 10.1007/s00261-005-0268-x.

12. Lechter A., Lopez G., Martinez C., Camacho J. Anatomy of the gonadal veins: a reappraisal. Surgery 1991;109(6):735–9. DOI: 10.1177/026835558700200311.

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17. Moore J., Kennedy S. Causes of chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol 2000;14(3): 389–402. DOI: 10.1053/beog.1999.0082.

18. Nasser F., Cavalcante R.N., Affonso B.B. et al. Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome. Int J Gynecol Obstet 2014;125(1):65–8. DOI: 10.1016/j.ijgo.2013.10.008.

19. Beard R.W., Highman J.H., Pearce S., Reginald P.W. Diagnosis of pelvic varicosities in women with chronic pelvic pain. Lancet 1984;2(8409):946–9. DOI: 10.1016/s0140-6736(84)91165-6.

20. Beard R., Reginald P., Wadsworth J. Slinical features of women with chronic lower abdominal pain and pelvic congestion. Br J Obstet Gynaecol 1988;95(2):153–61. DOI: 10.1111/j.1471-0528.1988.tb06845.x.

21. Foong L.C., Gamble J., Sutherland I.A., Beard R.W. Altered peripheral vascular response of women with and without pelvic pain due to congestion. BJOG 2000;107(2):157–64. DOI: 10.1111/j.1471-0528.2000.tb11684.x.

22. Punab M., Poolamets O., Paju P. et al. Causes of male infertility: a 9-year prospective monocentre study on 1737 patients with reduced total sperm counts. Hum Reprod 2017;32(1):18–31. DOI: 10.1093/humrep/dew284.

23. Zucker E.J., Ganguli S., Ghoshhajra B.B. et al. Imaging of venous compression syndromes. Cardiovasc Diagn Ther 2016;6(6):519–32. DOI: 10.21037/cdt.2016.11.19.

24. Steenbeek M.P., van der Vleuten C.J.M., Schultze Kool L.J., Nieboer T.E. Noninvasive diagnostic tools for pelvic congestion syndrome: a systematic review. Acta Obstet Gynecol Scand 2018;97(7): 776–86. DOI: 10.1111/aogs.13311.

25. Halligan S., Campbell D., Bartram C.I. et al. Transvaginal ultrasound examination of women with and without pelvic venous congestion. Clin Radiol 2000;55:954–8. DOI: 10.1053/crad.2000.0602.

26. Park S.J., Lim J.W., Ko Y.T. et al. Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonography. Am J Roentgenol 2004;182: 683–8. DOI: 10.2214/ajr.182.3.1820683.

27. Giacchetto G., Cotroneo G.B., Marincolo F. et al. Ovarian varicocele: ultrasonic and phlebographic evaluation. J Clin Ultrasound 1990;18:551–5. DOI: 10.1002/jcu.1870180705.

28. Hudson-Dixon C.M., Long B.W., Cox L.A. Power Doppler imaging: principles and Applications. Radiol Technol 1999;70:235–43.

29. Campbell D., Halligan S., Bartram C.I. et al. Transvaginal power Doppler ultrasound in pelvic congestion. Acta Radiol 2003;44:269–74. DOI: 10.1080/j.1600-0455.2003.00063.x.

30. Malgor R.D., Adrahtas D., Spentzouris G. et al. The role of duplex ultrasound in the workup of pelvic congestion syndrome. J Vasc Surg Venous Lymphat Disord 2014;2:34–8. DOI: 10.1080/j.1600-0455.2003.00063.x.

31. Yang D.M., Kim H.C., Nam D.H. et al. Time-resolved MR angiography for detecting and grading ovarian venous reflux: comparison with conventional venography. Br J Radiol 2012;1014:117–22. DOI: 10.1259/bjr/79155839.

32. Asciutto G., Mumme A., Marpe B. et al. MR venography in the detection of pelvic venous congestion. Eur J Vasc Endovasc Surg 2008;36:491–6. DOI: 10.1016/j.ejvs.2008.06.024.

33. Rozenblit A.M., Ricci Z.J., Tuvia J., Amis E.S. Jr. Incompetent and dilated ovarian veins: a common CT finding in asymptomatic parous women. Am J Roentgenol 2001;176:119–22. DOI: 10.1016/j.ejvs.2008.06.024.

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35. Kies D.D., Kim H.S. Pelvic congestion syndrome: a review of current diagnostic and minimally invasive treatment modalities. Phlebol Venous Forum R Soc Med 2012;27:52–7. DOI: 10.1258/phleb.2012.012s27.

36. Infertility definitions and terminology (WHO). Available at: https://www.who.int/reproductivehealth/topics/infertility/definitions/en.

37. Prikaz Minzdrava Rossii ot 30 avgusta 2012 g. № 107n «O poryadke ispol'zovaniya vspomogatel'nykh reproduktivnykh tekhnologiyakh, protivopokazaniyakh i ogranicheniyakh k ikh primeneniyu». Dostupno po: https://www.rosminzdrav.ru/documents/8023-prikaz-o-poryadke-ispolzovaniya-vspomogatelnyh-reproduktivnyh-tehnologiy-protivopokazaniyah-i-ogranicheniyah-k-ih-primeneniyu.

38. Post-reliz VII Mezhdunarodnyi kongress «Orgzdrav 2019», 24–25 aprelya 2019, Moskva. Dostupno po: https://www.vshouz.ru/orgzdrav2019/.