Feature Article

Pelvic venous disorders. Embracing the new SVP classification

Feature Article

Pelvic venous disorders. Embracing the new SVP classification

LAURENCIA VILLALBA, PETER CHIN

Figures

© mike Austin
© mike Austin

Abstract

Syndromic terminology for pelvic venous disorders, such as May-Thurner, nutcracker or pelvic congestion syndromes, should be abandoned and the new symptoms-varices-pathophysiology (SVP) classification embraced. This will help avoid confusion and allow clinicians to categorise these diverse patient populations into more homogeneous groups, enabling better comparisons, data analysis and treatment guidelines.

Key Points

  • The pelvic veins are interconnected with the lower limb veins. Pelvic venous disorders can thus cause a diverse range of symptoms, affecting the pelvis or the lower limbs.
  • Symptoms of pelvic venous disorders are reproducible and related to gravity and exercise and relieved by rest.
  • Pelvic venous compression and reflux are widely prevalent in the general population and symptom expression is not well understood.
  • Syndromic terminology should be abandoned in favour of the more concise SVP classification, which links symptoms, anatomy and pathophysiology and gives clinicians and patients a common platform for understanding and formulating management plans.
  • Patients with pelvic venous disorders that are considered clinically relevant can be treated safely and effectively with minimally invasive options.