What is Pelvic Congestion Syndrome?
Pelvic Congestion Syndrome is a vascular condition where varicose veins develop in the pelvic cavity, particularly the ovarian vein (close to the ovary). This can result in dull, chronic pelvic pain which can be exacerbated by standing for long periods, during and after intercourse, in the days before your period and in the last trimester of pregnancy.
Symptoms:
•dull chronic pelvic pain
•pain with intercourse
•back pain
•swelling of vulva or vagina
•varicose veins around legs, bottom or vulva
•hip pain
•abnormal bleeding during period
Causes:
•Hormonal changes during pregnancy
•Dysfunctional valves (stretched or weakened
•Iliac vein stenosis (narrowing of iliac vein)
Diagnosis:
•ultrasound scan - determine blood flow to area, can be used for different patient positionings
•venogram - dye is injected and x-ray taken, allows for veins to be seen
•laparoscopy - keyhole surgery to visualise the veins in the pelvic cavity
•MRI scan - magnetic resonance imaging can be used to see veins and dye can be injected to assist
•CT scan - contrast dye can be injected to allow for veins to be seen easily
Treatments:
• embolisation
• stenting of iliac artery
•non-steroidal anti-inflammatory drugs (e.g. ibuprofen)
• medications (e.g. pregabalin or gabapentin)
References
Brown, C.L., Rizer, M., Alexander, R., Sharpe, E.E. & Rochon, P.J.(2018). Pelvic congestion syndrome: systematic review of treatment success. Semin Interventional Radiology, 35(1), 35-40. https://dx.doi.org/10.1055%2Fs-0038-1636519
John Hopkins Medicine.(2022). Pelvic Pain (Pelvic Congestion Syndrome). Radiology and Radiological Science.
https://www.hopkinsmedicine.org/interventional-radiology/conditions/pelvic/
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