Venous intervention is associated with significant three-month improvement in pain, disease-specific quality of life and anxiety-depressive symptoms in patients with venous-origin chronic pelvic pain related to pelvic venous disorders (PeVD); however, greater baseline depressive symptom burden was associated with poorer short-term pain response.
Published in the journal CardioVascular and Interventional Radiology (CVIR), the single-centre observational cohort study was a retrospective analysis of prospectively collected institutional registry data led by Xiangtao Li (Beijing Shijitan Hospital, Beijing, China) and colleagues. A total of 103 women with symptomatic PeVD and venous-origin chronic pelvic pain who underwent venous intervention were included. Pain was assessed using a 0–10 numerical rating scale for average pelvic pain, disease-specific quality of life using the Pelvic Varicose Veins Questionnaire (PVVQ), and anxiety–depressive symptoms using the Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI). Outcomes were assessed at baseline and at three months. The authors define a good pain response as ≥50% reduction in Visual Analogue Scale (VAS) score.
The authors note that baseline VAS, PVVQ, BDI, HADS-A, and HADS-D scores were 7.41±0.9, 63.77±11.76, 16.95±8.7, 10.97±3.15, and 8.94±3.55, respectively. Clinically relevant anxiety symptoms (HADS-A ≥8), depressive symptoms (HADS-D ≥8), and BDI-defined depressive symptoms (BDI ≥14) were present in 80 (77.7%), 63 (61.2%), and 61 (59.2%) patients, respectively.
Following treatment, 80 patients (77.7%) experienced a good pain response, while BDI correlated with VAS improvement. After adjustment for age and baseline VAS, the authors note that each one-point increase in baseline BDI was associated with a 2.98%-point lower VAS improvement, and higher odds of poor pain response.
Concluding, the research team summarise that venous intervention was associated with significant three-month improvement in pain, although greater baseline depressive symptom burden was associated with less favourable short-term pain response. The authors add, however, that their findings are exploratory, and further research via multicentre studies with standardised PeVD phenotyping and longer-term follow-up are needed.
