Anxiety-Depressive Symptoms and Pain Response Following Venous Interventions for Venous-Origin Chronic Pelvic Pain Related to Pelvic Venous Disorders.

purposeTo evaluate whether baseline anxiety-depressive symptom burden is associated with 3-month pain response after venous interventions in women with venous-origin chronic pelvic pain related to pelvic venous disorders (PeVD). MATERIALS AND

methodsThis single-center observational cohort study was a retrospective analysis of prospectively collected institutional registry data. 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 3 months. Good pain response was defined as a ≥ 50% reduction in VAS score. Spearman correlation, multivariable linear regression, and Firth bias-reduced logistic regression were used.

resultsBaseline VAS, PVVQ, BDI, HADS-A, and HADS-D scores were 7.41 ± 0.90, 63.77 ± 11.76, 16.95 ± 8.70, 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. At 3 months, VAS decreased to 2.46 ± 2.55, PVVQ to 33.47 ± 17.74, BDI to 8.60 ± 9.55, HADS-A to 4.87 ± 4.79, and HADS-D to 4.90 ± 4.74 (all P < 0.001). Good pain response occurred in 80 patients (77.7%). Baseline BDI correlated with VAS improvement percentage (ρ = - 0.792, 95% CI - 0.855 to - 0.707, P < 0.001). After adjustment for age and baseline VAS, each one-point increase in baseline BDI was associated with a 2.98-percentage-point lower VAS improvement (95% CI - 3.38 to - 2.57, P < 0.001) and higher odds of poor pain response (adjusted OR 1.94, 95% CI 1.21-3.13, P = 0.006).

conclusionVenous intervention was associated with significant 3-month improvement in pain, disease-specific quality of life, and anxiety-depressive symptoms. Greater baseline depressive symptom burden was associated with less favorable short-term pain response. These findings are exploratory and require validation in multicenter studies with standardized PeVD phenotyping and longer follow-up.