Trans-venous occlusion of incompetent pelvic veins as a treatment for chronic pelvic pain in women: a pilot randomised control trial

Description

Method Pilot randomised trial in women aged 18-54 with pelvic vein incompetence and chronic pelvic pain

Background

Defined as continuous or intermittent lower abdominal or pelvic pain of at least six months duration (not occurring exclusively with menstruation, intercourse or pregnancy), CPP is widely accepted to be a major health problem with a worldwide prevalence in women of 24%. CPP primarily affects younger women, and is a leading cause of impaired quality of life, causing disruption to their daily life, social isolation, relationship difficulties and loss of work-related productivity. Over 18% of employed women take time off work due to CPP. Over 40% of women fail to achieve a diagnosis, with many discouraged and disengaged from the healthcare service despite continuing symptoms.

Pelvic vein incompetence (PVI) where the valves in the pelvic veins fail in the same way as they do in varicose veins, affects 15-20% of all women and yet we know little about it as the pelvic veins are emptied when women are tilted head-down to clear the gut from the pelvis during laparoscopy. There is increasing evidence that PVI may be an important cause of CPP. It is important and timely that the clinical and cost-effectiveness of pelvic vein occlusion be assessed in a pragmatic RCT.

People Professor Charles McCollum, Dr David Riding, Professor Ann Caress, Dr Mourad Seif,  Ms Judy Birch, Rae Larmour, Professor Linda McGowan et al.

Funding body: NIHR RfPB

Contact:  Professor Linda McGowan