Correlation between Pelvic Congestion Syndrome and Body Mass Index
Patrick Jasinski, MD, Ruhani Nanavati, MS, Demetri Adrahtas, MD, Nicos Labropoulos, PhD.
Stony Brook Medicine, Stony Brook, NY, USA.
OBJECTIVES: Pelvic Congestion Syndrome (PCS) is a diagnosis of exclusion for chronic pelvic pain and can be attributed to venous insufficiency with retrograde flow through ovarian, internal iliac, and pelvic veins. This study evaluates the correlation between body mass index (BMI) and PCS. Based on previous studies, we hypothesize patients with increased BMI are less likely to be diagnosed with PCS.
METHODS: A case-control study at a single institution was performed evaluating 100 patients who were diagnosed with PCS. BMI, recorded as weight (kg)/height (m)2, was calculated for every patient and categorized into normal weight (BMI <25), overweight (BMI 25-29.9), obese (BMI >30). Diagnosis of PCS was made utilizing transabdominal ultrasound and venograms in the study cohort. Mean BMI was compared across different age and racial groups, as well as compared with the mean BMI of the general female population of the United States from 1999-2002. Furthermore, analyses included a comparison of patients with and without ovarian vein dilation and pelvic varices.
RESULTS: Hundred women between ages 24 and 73 (median age 44) years were captured and analyzed. The mean BMI of the study group was 25 ± 5.6 kg/m2. The cohort was categorized into 59 women with normal BMI, 23 were overweight, and 18 women were obese. Study cohort BMI was less than general US female population (P = .02). The majority of the study group were Caucasian with lower BMI (P <.0001). Leg varicosities were more prevalent in obese patients (100% obese vs. 81% normal BMI, P = .01). Patients with ovarian vein dilation had significantly lower BMI (24.1 ± 5.6 kg/m2 and 26.7 ± 5.4 kg/m2, P = .036). No changes were identified for pelvic varices or reflux.
CONCLUSIONS: Women suffering from PCS are more likely to have a normal BMI with ovarian vein dilation as compared to obese women who are more frequently affected by leg varicosities.
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