? Companion Cases

Let’s meet our patient … Ms. C: Initial presentation? Ms. C is a 57 year old G3P2 post-menopausal woman who presents with one year of left lower quadrant pain? Nagging pain? Worse at night? Often presents late in the afternoon after prolonged periods of standing Chronic Pelvic Pain: Overview? Pelvic pain lasting greater than 6 months? Not cyclical or intercourse related? Often refractory to analgesic therapy with narcotics? Estimated cause of 10-40 % of outpatient gynecologist visits? Etiology often elusive? Patients can have extensive workups including laparoscopy in search of cause? Differential diagnosis is broad and includes endometriosis, adhesions, fibroids and pelvic varicosities As part of her workup for pelvic pain, Ms. C had a transvaginal ultrasound which showed dilated pelvic veins, compatible with pelvic congestion syndrome