Improvement of Symptoms and Health Related Quality of Life after Surgical Treatment in Patients with Pelvic Venous Disorders.

Abstract

Pelvic venous disorder (PVD) is an increasingly recognised cause of chronic pelvic pain and dyspareunia in women and may result from gonadal vein reflux, iliac venous outflow obstruction, or combined pathology. This study evaluated symptom relief and health related quality of life (HR-QoL) following surgical treatment of PVD. This was a retrospective cohort study of 51 women treated with endovascular and or open surgical interventions between January 2019 and October 2024. Symptoms were assessed using a 10 point visual analogue scale, and HR-QoL with the 36-Item Short Form Health Survey (SF-36) at baseline and follow up. Responsiveness was evaluated using Spearman's correlation between change scores and the standardised response mean. Median follow up was 12 months (interquartile range 12, 24). Pelvic pain and dyspareunia improved by 6 months (52% and 59% reduction, respectively; p < .001), with improvement maintained at 12 months; longer term outcomes were described in smaller exploratory subgroups. Complete symptom resolution occurred in 49% and 47%, respectively. All SF-36 domains improved at 6 and 12 months (p < .050). Bodily pain showed the most consistent alignment with symptom improvement. Combined iliac obstruction and gonadal reflux was present in 45% of patients, of whom 56% required staged multimodal treatment. Treatment was associated with improved symptoms and HR-QoL, particularly at 6 and 12 months. Among SF-36 domains, bodily pain showed the most consistent alignment with symptom reduction, although these findings should be interpreted as exploratory.