Pelvic Congestion Syndrome

Pelvic Congestion Syndrome (PCS) is a medical condition characterized by chronic pelvic pain. Frequently, patients go through years of being misdiagnosed and mismanaged before we see them. Although it could present in men, it tends to be more frequent in women. In females, it is associated with the presence of varicose veins in the pelvic area, particularly around the ovaries and uterus (you may not see these veins.)  These enlarged veins can cause a feeling of pelvic fullness, heaviness, and persistent discomfort.

Here are the key aspects of Pelvic Congestion Syndrome:

Causes:

Venous Insufficiency: Similar to varicose veins in the legs, PCS is often associated with venous insufficiency, where the valves in the veins do not function properly, leading to blood pooling and vein enlargement.

Pregnancy: The condition is more common in women who have been pregnant, likely due to increased pressure on pelvic veins during pregnancy.

Hormonal Factors: Hormonal changes, such as those associated with the menstrual cycle, may contribute to the development or exacerbation of symptoms.

Symptoms:

Chronic Pelvic Pain: The hallmark symptom of PCS is long-term pelvic pain that is often described as a dull, aching discomfort. The pain may be worse after long periods of standing or sitting.

Worsening Pain with Menstruation: Some women may experience an exacerbation of symptoms during or after menstruation.

Pelvic Discomfort: A feeling of fullness or heaviness in the pelvic area.

Backache: Pain in the lower back may also be present.

Painful Intercourse (Dyspareunia): Some women with PCS may experience pain during sexual intercourse or post-coital tenderness.

In males is more commonly associated with a condition called varicocele, characterized by the enlargement of the veins within the scrotum.

Diagnosis:

Imaging Studies: Ultrasound, computed tomography (CT) scans, or magnetic resonance imaging (MRI) may be used to visualize the pelvic veins and assess blood flow.

Venography: A contrast dye is injected into the veins, and X-rays are taken to provide detailed images of the blood vessels.

Treatment:

Conservative Measures: Lifestyle modifications, such as avoiding prolonged periods of standing or sitting, and the use of pelvic support garments may help alleviate symptoms.

Hormonal Treatment: In some cases, hormonal therapies, such as birth control pills, may be considered to regulate hormonal fluctuations that could contribute to symptoms.

Embolization: A minimally invasive procedure called embolization may be performed to block the abnormal veins and improve blood flow. This involves the insertion of a catheter into the affected veins, and embolic agents are used to close off the varicose veins.

It’s important for individuals experiencing chronic pelvic pain to seek medical evaluation for an accurate diagnosis. If Pelvic Congestion Syndrome is suspected, our vascular specialists can determine an appropriate treatment plan based on the severity of symptoms and individual patient factors.