VP59.46: The effect of uterine and ovarian pelvic pathology on uterine venous diameters

Pelvic pathology and dilated pelvic veins have been considered as potential contributors to pelvic pain. However, the of pelvic pathology on the pelvic venous circulation remains unknown.The aim of this study was to assess which type of pelvic pathologies had a dilating effect on uterine venous diameters (UVD). This was an observational study. A single operator performed all the transvaginal ultrasound (TVS) scans. Exclusion criteria included: age<18 years, unable to undergo TVS or history of hysterectomy. The uterine veins were identified originating at the level of the internal os and traced laterally in the base of the broad ligament to the iliac vessels.The UVD was measured in all women at a standardised reference point. We examined 1,500 women and 1,013 (67.5%) had evidence of pelvic pathology. Fibroids (49%) and adenomyosis (38.7%) were the most common pathologies diagnosed on TVS. The median UVD for the left and right side were 3.2mm [IQR 2.6, 4.1] and 3.3mm [2.6, 4.2] respectively. There was no difference between both UVD (p = 0.07).Fibroids were the only type of pathology that were significant in influencing UVD and were associated with an 8% increase in diameter size. The size of the fibroid was also an important factor. When categorised into large fibroids (>50mm), UVDs were 24% larger than in women without fibroids (<0.001). Women with fibroids on TVS had larger UVDs. Additionally, UVD increased exponentially with increasing fibroid mean diameters. This highlights that these factors need to be considered when assessing the pelvic venous circulation and that a single value cannot be used as the threshold for dilated UVD. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.