Kongestivni zdjelični sindrom

master's thesis

• Title (english): Pelvic congestion syndrome
• Author: Sandra Šparac
• Mentor: Vanja Fenzl (mentor)
• Committee member: Željko Duić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Vanja Fenzl (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Kongestivni zdjelični sindrom često je neprepoznat uzrok kronične zdjelične boli kod žena, a karakteriziraju ga dilatirane i insuficijentne zdjelične vene. Najčešće zahvaća višerotkinje u premenopauzalnoj dobi. Venska insuficijencija primarno nastaje zbog dilatacije lumena pod utjecajem hormonskih i mehaničkih čimbenika, no može nastati i sekundarno kao posljedica vanjske kompresije. Tipičnu kliničku sliku čini kronična unilateralna ili bilateralna bol u zdjelici, udružena s dismenorejom, dispareunijom i/ili iritacijom mokraćnog mjehura. Pridruženi nalaz mogu biti varikoziteti vulve te varikoziteti donjih udova. Patofiziološki, bol nastaje kao posljedica rastezanja tunicae intimae vena zbog volumnog opterećenja, no može biti i posljedica kompresije na priležeće živce. Dilatacija vena zdjelice kao izolirani nalaz kod asimptomatskih bolesnica nije indikacija za liječenje.
Neinvazivne dijagnostičke metode za potvrdu kongestivnog zdjeličnog sindroma uključuju klasični ultrazvuk (transvaginalni, transabdominalni, transperinealni), doppler ultrazvuk, kompjutoriziranu tomografiju (CT) i magnetsku rezonanciju (MR). Invazivne dijagnostičke metode su venografija i laparoskopija. Zlatni standard za dijagnozu kongestivnog zdjeličnog sindroma je venografija. U liječenju bolesnica koriste se potporna i medikamentozna terapija kao konzervativne metode te invazivne kirurške ili radiološke metode.

Abstract (english)

Pelvic congestion syndrome is one of the causes of chronic pelvic pain in women characterized by varicose and insufficient pelvic veins. Most often it affects multiparous women of premenopausal age. Venous insufficiency primarily occurs because of the lumen dilatation due to hormonal and mechanical factors. It can also occur secondarily, as a result of external compression. The typical clinical presentation is chronic, unilateral or bilateral pelvic pain, associated with dysmenorrhea, dyspareunia and/or bladder irritation. Vulvar varicosities and varicose veins of the lower limbs are often present. Pathophysiologically, pain develops as a result of the stretching of tunica intima due to the volume load, but it can also be a consequence of nerve compression. The varicose pelvic veins as an isolated finding in asymptomatic patients are not an indication for treatment. Ultrasound (classic and doppler), computed tomography (CT), magnetic resonance imaging (MRI) and venography are diagnostic procedures of choice for PCS. Venography is the gold standard for the diagnosis of PCS. Non-invasive therapeutic options are supportive and medical therapy. Surgical and radiological treatments are considered as invasive therapeutic options.

• Keywords: kongestivni zdjelični sindrom; zdjelična venska insuficijencija; varikoziteti; venografija
• Keywords (english): Pelvic Congestion Syndrome; Pelvic Venous Insufficiency; Varicosities; Venography
• Language: croatian
• URN:NBN: urn:nbn:hr:105:955555
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-03-06 08:17:19