Pelvic Congestion Syndrome and Pelvic Adhesions

This chapter reviews the ultrasound findings of two causes of pelvic pain: pelvic congestion syndrome and pelvic adhesions. Pelvic congestion is a known cause of chronic pelvic pain. It is usually associated with intrapelvic varicose veins in women with unexplained pain in the hypogastrium or pelvis that lasts more than 6 months. Adhesion syndrome or pelvic adhesions, also known as peritoneal inclusion cysts and benign cystic mesothelioma among other names, is defined by symptoms and signs borne by intra-abdominal adhesions. Pelvic adhesions may cause chronic or long-term pain. Adhesions that limit movement of pelvic structures and organs are painful, especially those that affect ovaries and fix the uterus and the omentum. Nerves have been found in pelvic adhesions; however, they have not always been found in those of symptomatic patients. These findings suggest that adhesions go through different stages, leading to mature fibrous tissue with its own vessels and nerves.