[Interventional radiological treatment of uterine fibroids and pelvic congestion syndrome for pain reduction].

backgroundChronic pelvic pain in women is often multifactorial and associated with a marked impairment in quality of life. Among the most common structural causes are symptomatic uterine fibroids and pelvic congestion syndrome.

objectivesThis review provides an overview of interventional radiological treatment options for both conditions, with a focus on pain reduction and clinical effectiveness. MATERIALS AND

methodsCurrent reviews, meta-analyses, and clinical studies on uterine artery embolization (UAE), magnetic resonance (MR-)high-intensity focused ultrasound (HIFU), and radiofrequency and microwave ablation for the treatment of symptomatic uterine fibroids, as well as pelvic vein embolization for pelvic congestion syndrome, were summarized.

resultsIn uterine fibroids, UAE, HIFU/MR-HIFU, and thermal ablation techniques improve symptoms and quality of life. UAE is particularly well established for multiple and large fibroids, whereas HIFU and thermal ablation techniques appear especially suitable for selected, more focal lesions. In pelvic congestion syndrome, meta-analyses demonstrate a marked and sustained reduction in pain following pelvic vein embolization.

conclusionInterventional radiological procedures represent effective organ-preserving treatment options for both conditions. While the analgesic effect in pelvic congestion syndrome is usually demonstrated directly by pain scales, in fibroid therapies it is generally assessed only indirectly through symptom and quality-of-life parameters. Standardized assessment of pain could help to define patient-relevant benefit more clearly in future studies.