Pelvic congestion syndrome presenting as persistent genital arousal : A case report

Introduction. Persistent sexual arousal is defined as an intrusive and unwanted genital arousal unrelated to sexual desire and typically unrelieved by one or more orgasms.Aim. We report a patient presented with persistent sexual or genital arousal.Methods. A 62-year-old woman presented with a 5-month history of persistent genital arousal. The symptoms were unrelated to sexual stimuli but were relieved incompletely and temporarily by orgasm.Results. Doppler ultrasound demonstrated multiple pelvic varices. Magnetic resonance imaging (MRI) demonstrated varices in the pelvis, the vaginal wall, perineum, inguinal region, and anterior abdominal wall. Coil embolization of the dilated incompetent left ovarian vein was performed with marked reduction of symptoms.Conclusion. We proposed that the syndrome of persistent genital or sexual arousal in women warrants a careful and systematic examination for pelvic venous incompetence by Doppler ultrasound and MRI or computerized tomography, with appropriate tilt positioning and Valsalva maneuver, before assigning it to a central neurologic or Psychologic etiology.