AVF Pelvic Venous Summit: Overlap, Outcomes, and Physiatry
Diagnostic Overlap in Chronic Pelvic Pain
Pelvic venous disorders rarely occur alone, sharing symptoms like dyspareunia and non-menstrual pain with endometriosis, adenomyosis, IBS, and interstitial cystitis, so research excluding overlapping conditions produces cleaner data that is less generalizable to real patients.
Quantifying Impact With a New Outcome Measure
Concept elicitation interviews for a new outcome measure found venous origin chronic pelvic pain affects patients all month rather than cyclically, with SF-36 and PROMIS scores as impaired as endometriosis patients and 62 percent screening positive for central sensitization.
A Physiatry Approach to Musculoskeletal Pelvic Pain
About 85 percent of chronic pelvic pain patients have musculoskeletal dysfunction, so a physiatry exam screens the spine, hips, and pelvic floor for reproducible pain, guiding referral to pelvic floor therapy, trigger point injections, or Botox for high-tone dysfunction.
Confounders and the Case for Multidisciplinary Phenotyping
Panelists debated how overlapping pain generators confound outcome studies, since a patient’s dominant diagnosis is often a clinical judgment rather than a certainty, reinforcing calls for standardized phenotyping and multidisciplinary decision making across specialties.
