Steve Elias, MD
Charles E. Miller, MD, FACOG
Advancing the Understanding of Chronic Pelvic Pain
A multidisciplinary effort to improve awareness, diagnosis, collaboration, and treatment pathways for women affected by pelvic venous disease.
Chronic pelvic pain is often a disruptive condition that significantly reduces quality of life for affected women.
Diagnostic workup generally includes evaluation of gynecologic concerns such as endometriosis, adenomyosis, uterine fibroids, and ovarian cysts, as well as non-gynecologic disorders including irritable bowel syndrome, interstitial cystitis, and pelvic floor myalgia.
This extensive range of testing often leads to a multidisciplinary approach involving gynecologists, gastroenterologists, urologists, urogynecologists, and pelvic floor therapists. For many women, this coordinated regimen provides meaningful pain relief.
A Growing and Overlooked Concern
Over 10 million people in the United States are impacted by debilitating pelvic pain.
Despite multimodal treatment strategies and overall therapeutic success, many patients continue to suffer from persistent symptoms that may ultimately be linked to pelvic venous disease (PVD).
According to the literature, the etiology of upwards of 30% of women with chronic pelvic pain may be pelvic venous disease. Despite this, many gynecologists remain unaware of the impact of PVD on chronic pelvic pain, the diagnostic pathway required to identify the disorder, and the available treatment armamentarium.
As gynecologists are often the physicians who initiate the workup and coordinate referrals, venous disease evaluation has historically been overlooked. This gap in awareness has delayed timely diagnosis and referral to vascular specialists for treatment discussions.
This lack of understanding must change. Timely referral pathways are essential for accurate diagnosis and effective treatment.
A Need for Individualized Care
With life expectancy for women increasing more rapidly than their male counterparts — and with pelvic venous disease often diagnosed at a young age — individualized treatment planning becomes increasingly important.
The potential impact of future pregnancies, reproductive health considerations, and long-term disease progression must all be incorporated into the management strategy.
A clear understanding of the underlying venous pathology must be paired with evidence-based treatment approaches while thoughtfully considering both the effects of reproduction and the effects on reproduction.
Ultimately, this treatment plan should exist within a broader multidisciplinary continuum of care.
Building a Multidisciplinary Pathway Forward
To address the growing need for standardized pathways in the diagnosis and treatment of pelvic venous disease, the American Venous Forum has organized a unique multidisciplinary conference focused on women experiencing chronic pelvic pain secondary to PVD.
The conference brings together vascular specialists, gynecologists, interventional radiologists, and physical therapy and rehabilitation experts to improve collaboration and elevate standards of care.
The ultimate goal of the conference is to foster greater understanding of chronic pelvic pain and pelvic venous disease while strengthening interdisciplinary collaboration among the medical professionals caring for these patients.
This educational initiative represents an important step toward improved diagnosis, referral pathways, and patient-centered treatment strategies.
See you in Chicago!