Does Pelvic Congestion Cause Bladder Symptoms—Potential New Indication to Treat Pelvic Congestion

Wai Yan Timothy Wong, Man Yeuk Cheung, MICHELLE CHEUNG, Bevan Brown, Eisen Liang
In: Journal of Medical Imaging and Radiation Oncology · 2025 · vol. 69(2) , pp. 221–227 · doi:10.1111/1754-9485.13834 · PMID:39838576 · W4406723918
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that bladder symptoms are common in women with pelvic congestion syndrome and that ovarian vein embolization effectively alleviates these symptoms.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This retrospective cohort study examined the prevalence of bladder symptoms in women diagnosed with pelvic congestion syndrome (PCS) and assessed whether ovarian vein embolisation (OVE) alleviated those symptoms. Among 123 women who had radiological evidence of PCS and underwent OVE, 65% reported bladder symptoms before the procedure, with the most common being daytime frequency, incomplete emptying, and nocturia. Of the 80 women with bladder symptoms, 75% reported improvement after OVE, including complete resolution in 13.8% and significant improvement in 37.5%, with no major complications or mortality reported; the study’s major limitation is that follow-up outcomes were collected via a web-based survey and the design was retrospective. Relevance to endometriosis: the paper does not explicitly discuss endometriosis or adenomyosis, but it was included in the corpus via a keyword match in the upstream search index.

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Abstract

BACKGROUND: Pelvic Congestion Syndrome (PCS) is a condition characterised by chronic pelvic pain resulting from the dilation and reflux of veins within the pelvis. While pelvic pain is the primary symptom of PCS, other associated symptoms may vary among individuals. Bladder symptoms have been commonly observed in PCS, including increased urination frequency, urinary urgency, nocturia and rarely haematuria. This study aimed to investigate the prevalence of bladder symptoms in women with pelvic congestion syndrome and the effectiveness of Ovarian Vein Embolisation in alleviating these symptoms. METHODS: This was a retrospective cohort study on women diagnosed with PCS between January 1, 2017, and December 31, 2022. Inclusion criteria were defined as the presence of clinical symptoms and radiological evidence of PCS undergoing Ovarian Vein Embolisation (OVE). Participants were followed up at least 6 months post-procedure using a web-based survey to assess their bladder symptoms. RESULTS: One hundred and twenty-three women underwent OVE for PCS during the study period and consented to participate in the study, and 65% (n = 80) reported experiencing bladder symptoms. The most common bladder symptoms during pre-procedure consultations included daytime frequency, a sense of incomplete emptying, and nocturia. Among the individuals with bladder symptoms, 60/80 (75%) reported symptom improvement following OVE. Furthermore, 11/80 patients (13.8%) noted a complete resolution of their symptoms post-OVE, and 30/80 patients (37.5%) reported significant improvement. There were no reported major complications or mortality following OVE. CONCLUSION: The findings of this study provided compelling evidence that bladder symptoms are common in women with PCS. Ovarian Vein Embolization emerges as a safe and effective intervention for alleviating concurrent bladder symptoms in these patients.
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Abstract

Background Pelvic Congestion Syndrome (PCS) is a condition characterised by chronic pelvic pain resulting from the dilation and reflux of veins within the pelvis. While pelvic pain is the primary symptom of PCS, other associated symptoms may vary among individuals. Bladder symptoms have been commonly observed in PCS, including increased urination frequency, urinary urgency, nocturia and rarely haematuria. This study aimed to investigate the prevalence of bladder symptoms in women with pelvic congestion syndrome and the effectiveness of Ovarian Vein Embolisation in alleviating these symptoms.

Methods

This was a retrospective cohort study on women diagnosed with PCS between January 1, 2017, and December 31, 2022. Inclusion criteria were defined as the presence of clinical symptoms and radiological evidence of PCS undergoing Ovarian Vein Embolisation (OVE). Participants were followed up at least 6 months post-procedure using a web-based survey to assess their bladder symptoms.

Results

One hundred and twenty-three women underwent OVE for PCS during the study period and consented to participate in the study, and 65% (n = 80) reported experiencing bladder symptoms. The most common bladder symptoms during pre-procedure consultations included daytime frequency, a sense of incomplete emptying, and nocturia. Among the individuals with bladder symptoms, 60/80 (75%) reported symptom improvement following OVE. Furthermore, 11/80 patients (13.8%) noted a complete resolution of their symptoms post-OVE, and 30/80 patients (37.5%) reported significant improvement. There were no reported major complications or mortality following OVE.

Conclusion

The findings of this study provided compelling evidence that bladder symptoms are common in women with PCS. Ovarian Vein Embolization emerges as a safe and effective intervention for alleviating concurrent bladder symptoms in these patients. Conflicts of Interest The authors declare no conflicts of interest. Data Availability Statement The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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