Taskin O, Uryan I, Buhur A, Burak F, Erden F, Atmaca R, Wheeler M
Department of Obstetrics, Gynecology, and Pharmacology, Inonu University Medical School, Malatya, Turkey.
J Am Assoc Gynecol Laparosc. 1996 Aug;3(4, Supplement):S49.
The syndrome of chronic pelvic pain without an obvious pathology has been described as pelvic congestion (Taylor) syndrome. It is frequently associated with continuous bilateral lower abdominal pain and dyspareunia. Pelvic examination reveals tenderness without induration or masses. Although their importance in the pathophysiology of pain is uncertain, prominent enlarged broad ligament veins are observed at laparoscopy. We evaluated the effects of daflon, a venomimetic agent that regulates the circulatory tonus of the venous system, on pelvic pain and investigated the role of enlarged veins in the pathophysiology of Taylor syndrome. Ten women (age 28-35 yrs) with chronic pelvic pain were diagnosed with the syndrome at laparoscopy. They all had prominent broad ligament and ovarian veins without other pathologies such as endometriosis to explain the etiology of pelvic pain. Five women were randomized in a double-blind fashion to receive daflon 500 mg twice/day for 4 months, and five a vitamin pill placebo; they were crossed over for another 4 months. They scored the frequency and severity of lower abdominal pain and dyspareunia on a scale from 0 to 6, and the results were compared with pretreatment values. At the end of the fourth month the frequency and severity of pelvic symptoms began to decrease with daflon compared with pretreatment and placebo. The mean scores were significantly less at the end of 4 months (9.3 ± 1.1 vs 4.2 ± 1.4, respectively, p <0.05). Based on our preliminary results, we conclude that venous dysfunction and stasis may be pathophysiologic components of pelvic pain in women with Taylor syndrome. Pharmacologic enhancement of venous tonus may restore pelvic circulation and relieve pelvic symptomatology.
无明显病理改变的慢性盆腔疼痛综合征被描述为盆腔淤血（泰勒）综合征。它常伴有持续性双侧下腹部疼痛和性交困难。盆腔检查发现有压痛，但无硬结或肿块。尽管它们在疼痛病理生理学中的重要性尚不确定，但在腹腔镜检查时可观察到显著增粗的阔韧带静脉。我们评估了达芙通（一种调节静脉系统循环张力的类蛇毒制剂）对盆腔疼痛的影响，并研究了扩张静脉在泰勒综合征病理生理学中的作用。10名患有慢性盆腔疼痛的女性在腹腔镜检查时被诊断为此综合征。她们均有显著增粗的阔韧带和卵巢静脉，且无其他诸如子宫内膜异位症等可解释盆腔疼痛病因的病变。5名女性以双盲方式随机分组，接受每日两次、每次500毫克达芙通治疗，共4个月，另外5名服用维生素片安慰剂；之后她们交叉治疗4个月。她们根据0至6分的量表对下腹部疼痛和性交困难的频率及严重程度进行评分，并将结果与治疗前值进行比较。在第四个月末，与治疗前和安慰剂相比，服用达芙通后盆腔症状的频率和严重程度开始下降。4个月末的平均评分显著降低（分别为9.3±1.1和4.2±1.4，p<0.05）。基于我们的初步结果，我们得出结论，静脉功能障碍和淤血可能是泰勒综合征女性盆腔疼痛的病理生理组成部分。药理学增强静脉张力可能恢复盆腔循环并缓解盆腔症状。
