الفهرس 
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Abstract
Chronic pelvic pain is extremely common in women of child-bearing
age. There are numerous causes of chronic pelvic pain. Pelvic venous
congestion and pelvic varices have increasingly been identified as the causes
of chronic pelvic pain.
Our study included 120 patients; all patients had a history of chronic
pelvic pain for more than 6 months. The prevalence of pelvic varicose veins
according to transvaginal ultrasound (TVUS) was 28.3% (34 positive cases
out of 120). While the diameter of pelvic veins was observed to be
bilaterally >5 mm in 14 patients, it was right sided in 9 and left sided in 11.
Most (73.6%) of women with pelvic varices presented in their
twenties and thirties. Multiple pregnancies were found to be a risk factor for
developing pelvic varices. Patients with pelvic varices complained of
chronic pelvic pain for more than 6 months increased with prolonged
standing. Other complaints included post-coital ache in 76.47%,
dysmenorrhagia in 76.47%, dyspareunia in 73.53%, and other associated
symptoms were also noted including urinary symptoms (frequency, dysuria,
and urgency) in 55.88% of patients and low back pain in 32.35 % patients.
More than one symptom was present in the same patient. Ovarian point of
tenderness was found in 70.59 % of patients on physical examination.
Patients with pelvic varices had associated perineal regions, buttock, vulvar
and upper thigh (medial and posterior) varicosities in 76.47% of patients.
Ultrasonographically a normal pelvic venous plexus appears as one or
two small, smooth tubular structures that are <5 mm in diameter, pelvic
varices typically appeared as: multiple dilated structures (greater than 5 mm)
around the uterus and ovaries with venous Doppler signal that showed slow
blood flow (<3 cm/sec) and commonly associated with dilated arcuate veins
in the myometrium communicating between pelvic varicose veins in both
sides and polycystic changes of the ovaries.