Pelvic congestion syndrome overview

Pelvic pain is a common symptom affecting 33% of women in their lifetimes. Chronic pelvic pain is a lower abdominal symptom that has been present for more than 6 months without a clear etiology.
Pelvic congestion syndrome, also known as pelvic vein congestion syndrome or ovarian vein reflux, can be the cause of pelvic pain in up to 10-40% of cases.

 
 

Dr. Julian Javier discusses varicocele and pelvic congestion syndrome which can cause groin pain.

 
 

Pelvic congestion syndrome causes

The anatomical etiology of pelvic congestion syndrome is a dysfunctional pelvic vein. The affected vein exhibits insufficiency (leak) and causes an abnormally large amount of blood refluxing into the ovaries and pelvis, hence the name “congestion syndrome”.

The cause of the pelvic venous leak is incompletely known. Hormonal and mechanical changes that occur during pregnancy are commonly identified as risk factors for the development of the pelvic congestion syndrome.

There are other, less common, anatomical variants that can be associated with pelvic congestion syndromes.

Pelvic congestion syndrome symptoms

Symptoms may include:

  • A dull ache in the lower abdominal area

  • A dull pelvic ache that worsens during your menstrual period

  • Urinary urgency or incontinence

  • Painful sexual intercourse

  • Varicose veins in the pelvic area

  • Varicose veins in the upper thighs

  • Varicose veins in the vaginal area

Pelvic congestion syndrome diagnosis

Your doctor will obtain a medical history and review your symptoms in detail. A physical examination, including a genital examination, is performed to evaluate the potential source of your varicose veins. You may have experienced symptoms for years prior to arriving at a diagnosis because a high index of suspicion is necessary. After the history and physical are performed, your doctor may recommend diagnostic techniques, such as :

  • Pelvic ultrasound

  • Computed tomography venography (CTV)

  • Magnetic resonance venography (MRV)

  • Venogram

Pelvic congestion syndrome treatment

This condition is treated by two minimally invasive procedures:

  • Vein Embolization- A catheter is guided to the leaking pelvic or ovarian vein and coils are used to close the vein, thereby stopping the reflux.

  • Sclerotherapy- A catheter is guided into the faulty vein where a chemical foam is injected into the vein in order to seal it.

 

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