Chronic pelvic pain due to bilateral primary ovarian vein reflux. A dilated, refluxing left ovarian vein (black arrow) is associated with multiple pelvic varicosities (white arrow). Right ovarian vein reflux is also present, but not demonstrated in this image. No obstruction of the left renal or common iliac veins or internal iliac reflux is present by ultrasound examination. The Symptoms-Varices-Pathophysiology (SVP) classification is S2V2PBGV,R,NT.