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Up to 80% of patients undergoing bariatric surgery are women and most of them are in childbearing age. Weight loss in those patients results in increased fertility in a short time postoperatively. Although women after bariatric procedure have an improved maternal and fetal outcome during pregnancy and in the postpartum period compared to women with untreated obesity, conceiving during the time of rapid weight loss is associated with higher rates of nutritional deficiencies and obstetric complications. Therefore women who receive surgical treatment for obesity are advised not to conceive for the following 12–18 months both to ensure optimal weight loss and to begin pregnancy with optimal nutritional and vitamin status. Before choosing a contraceptive method, both safety and efficacy in the pre– and post–weight loss period should be considered. The UK Faculty for Sexual and Reproductive Health advises using long-acting reversible contraceptives for the first 2 years after surgery.

Objectives Pelvic congestion syndrome is defined as chronic pelvic pain due to incompetent (dilated and refluxing) pelvic veins. The aim of this study was to investigate the prevalence of this condition by examining the prevalence of dilated ovarian and para-uterine veins in pre- and postmenopausal female patients, irrespective of their symptoms. We subsequently investigated how many women with dilated veins suffered from chronic pelvic pain. Additionally, we attempted to define diagnostic criteria that may allow for early identification of affected patients. Methods We reassessed 2384 abdomino-pelvic computed tomography scans performed on women at our institution. The maximal diameters of the ovarian and para-uterine veins were measured. Patients with a pathological process in the abdomen or pelvis affecting the veins were excluded. We considered ovarian vein dilation to be 6 mm or more in the axial plane. For patients that met these criteria, we performed a retrospective chart review to evaluate the clinical presentation and/or symptoms of these patients. Results Dilated pelvic veins were present in 293/2384 (12%) patients, 118/559 premenopausal (21%) and 175/1825 postmenopausal (10%). Chronic pelvic pain of unclear etiology had been documented prior to the CT in 54/293 (18%) women with dilated veins—2% of the whole study collective (54/2384); 8% of all premenopausal (44/559) and 0.5% of all postmenopausal (10/1825). It was often accompanied by urological symptoms such as hematuria, dysuria, and urinary frequency, in the absence of infection (p