It's Time to Recognise Pelvic Venous Incompetence as a Cause of Chronic Pelvic Pain

Summary Pelvic venous disorder (PeVD) is an under‐recognised cause of chronic pelvic pain (CPP). Routine pelvic ultrasound rarely includes assessment of the pelvic veins, despite being well positioned to identify features of PeVD. A limited venous assessment can be incorporated into a routine pelvic ultrasound, analogous to varicocele assessment in men. Adnexal vein size alone is an unreliable indicator of disease; Doppler‐confirmed reflux is essential for diagnosis. Transvaginal Doppler ultrasound (TVDUS) is emerging as a clinically meaningful and efficient tool for assessing pelvic venous function. Integrating pelvic venous assessment into routine pelvic scanning may improve diagnostic recognition, support timely referral and enhance patient outcomes.