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GV diameter was measured on venous-phase computed tomography\/magnetic resonance imaging by two readers, or from ultrasound when unavailable. Proximal VOO was ascertained by highest-confidence available testing and evaluated with logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 200 patients (mean age, 52.4\u2009\u00b1\u200917.0\u00a0years), 84 (42.0%) were symptomatic and 116 (58.0%) asymptomatic. Mean GV diameter did not differ by symptom status (8.89\u2009\u00b1\u20092.29 vs 9.43\u2009\u00b1\u20092.50\u00a0mm;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.121) and was not associated with symptoms in crude (odds ratio [OR], 0.91 per mm; 95% confidence interval [CI], 0.80\u20131.03) or adjusted analysis (adjusted OR [aOR], 0.97 per-mm; 95%\u00a0CI, 0.81\u20131.14). Proximal VOO was assessable in 189 patients and more common in symptomatic vs asymptomatic patients (32.9% vs 2.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), as were lower-extremity (LE) varices (44.0% vs 12.9%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and superficial pelvic varicosities (28.6% vs 1.7%; all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). In the adjusted model, younger age (aOR, 0.50 per 10\u00a0years; 95% CI, 0.39\u20130.65), LE varices (aOR, 9.80; 95% CI, 3.76\u201325.50), and any proximal VOO (aOR, 10.89; 95% CI, 2.66\u201344.55) were independently associated with symptomatic status. Discrimination was acceptable (c-statistic, 0.82; 95% CI, 0.76\u20130.89) and unchanged by GV diameter.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among women with pelvic varices, GV diameter was not associated with PeVD-consistent symptoms and added no incremental predictive value beyond age, LE varices, and VOO. Comorbid venous disease and outflow obstruction may better distinguish clinically significant PeVD than diameter thresholds alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00270-026-04493-5","type":"journal-article","created":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T19:24:40Z","timestamp":1780860280000},"page":"1268-1277","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Compression and Superficial Varicosities Outperform Gonadal Vein Diameter in Differentiating Symptomatic from Asymptomatic Pelvic Venous Disorders: A Case\u2013Control Study"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4182-5323","authenticated-orcid":false,"given":"Estefania","family":"Gonzales","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Risner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourens","family":"du Pisanie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Keefe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Mody","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marueen P.","family":"Kohi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Salazar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"4493_CR1","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1055\/s-0042-1757938","volume":"39","author":"RW Ford","year":"2022","unstructured":"Ford RW, Winokur RS. 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NK reports consulting fees from Medtronic and Centerline Biomedical. MK reports consulting fees from Boston Scientific and Penumbra and leadership roles within SIR. GS reports consulting fees from Boston Scientific, Medtronic, Cook, BD, Optimed, and TriSalus; honoraria from Boston Scientific, Medtronic, Cook, BD, Penumbra, and Philips; and leadership roles within SIR, AVLS, AVF, and SIDI. The remaining authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this retrospective study, the Institutional Review Board at the University of North Carolina at Chapel Hill approved the study (IRB #23\u20131570).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"For this type of study consent for publication is not required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"This study has obtained IRB approval from the University of North Carolina at Chapel Hill, and the need for informed consent was waived.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}},{"value":"Presented as an\n                      oral presentation\n                      at the\n                      CIRSE Annual Congress\n                      , Barcelona, Spain (September 13\u201317, 2025).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Prior Presentation"}}]}}