{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:58:51Z","timestamp":1780894731154,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T00:00:00Z","timestamp":1682294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PB\u2010PG\u20100317\u201020040"],"award-info":[{"award-number":["PB\u2010PG\u20100317\u201020040"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.pericles-gcp.literatumonline.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the association between chronic pelvic pain (CPP) and pelvic vein incompetence (PVI) or pelvic varices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Gynaecology and vascular surgery services in two teaching hospitals in north\u2010west England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>A total of 328 premenopausal women (aged 18\u201354\u2009years), comprising 164 women with CPP and 164 matched controls with no history of CPP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Symptom and quality\u2010of\u2010life questionnaires and transvaginal duplex ultrasound for PVI and pelvic varices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Venous reflux of &gt;0.7\u2009s in the ovarian or internal iliac veins (primary outcome) and presence of pelvic varices (secondary outcome). Statistical analysis compared the prevalence of PVI between women with and without CPP using the two\u2010sided chi\u2010square test. Logistic regression was used to compare the odds of having PVI and pelvic varices between women with and without CPP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pelvic vein incompetence was found on transvaginal duplex ultrasound in 101\/162 (62%) women with CPP, compared with 30\/164 (19%) asymptomatic controls (OR\u20096.79, 95%\u2009CI 4.11\u201311.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Forty\u2010three of 164 (27%) women with CPP had pelvic varices compared with three of 164 (2%) asymptomatic women (OR\u200918.9, 95%\u2009CI 5.73\u201362.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There was a significant association between PVI, as detected by transvaginal duplex imaging, and CPP. Pelvic varices were strongly associated with CPP and were infrequently seen in control patients. These results justify further evaluation of PVI and its treatment in well\u2010designed research.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17485","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T04:00:11Z","timestamp":1682395211000},"page":"1355-1361","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Pelvic vein incompetence and chronic pelvic pain: a case\u2013control study"],"prefix":"10.1111","volume":"130","author":[{"given":"Vivak","family":"Hansrani","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Riding","sequence":"additional","affiliation":[{"name":"Manchester Vascular Centre Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mourad W.","family":"Seif","sequence":"additional","affiliation":[{"name":"St\u2009Mary's Hospital, Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann\u2010Louise","family":"Caress","sequence":"additional","affiliation":[{"name":"Health Services Research, Department of Nursing and Midwifery, School of Human and Health Sciences University of Huddersfield  Huddersfield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Payne","sequence":"additional","affiliation":[{"name":"Institute of Population Health University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles N.","family":"McCollum","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, School of Medical Sciences University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c4834"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1348\/135910706X104076"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.2631"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2022.02.008"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0b013e3181e0976f"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3310\/hta20050"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0268355518821554"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2014.01.030"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2020.12.084"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1074-3804(05)60156-9"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-015-1074-7"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/16.5.931"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.201.131"},{"key":"e_1_2_12_15_1","volume-title":"Royal College of obstetrics and Gynaecology green\u2010top guideline: the initial management of chronic pelvic pain","author":"Moore SJ","year":"2012"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1708538116670499"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1677-54492010000200002"},{"key":"e_1_2_12_18_1","unstructured":"EQ\u20105D 3 Level.Euroqol Group. 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