Pelvic Congestion Syndrome

Pelvic Congestion Syndrome

Pelvic Congestion Syndrome (PCOS) is one of the known causes of chronic pelvic pain.
Chronic pelvic pain is pain that has been present for more than 6 months and affects 15% of women. Of these 30% are due to underlying pelvic congestion.

What does Pelvic Congestion Syndrome mean?

Pelvic congestion syndrome is due to varicose veins within the pelvis – usually originating from the ovarian veins. The veins become enlarged or dilated within the pelvis causing symptoms.

What are symptoms of pelvic congestion syndrome?

  • Non-cyclical, positional lower back, pelvic and upper thigh pain
  • Difficult or painful sexual intercourse
  • Difficult or painful urination
  • Symptoms worsen throughout the day and are exacerbated by activity or prolonged standing.
  • Pain relieved by lying down.
  • High thigh veins, groin veins, vulval veins, veins underneath buttocks

Who typically gets pelvic congestion syndrome?

  • Women of childbearing age 20-40
  • Usually having borne more than one child
  • Usually slim

How is pelvic congestion syndrome diagnosed?

As there are many causes for pelvic pain, one should be fully examined by a gynaecologist to exclude common causes such as:

  • Endometriosis
  • Fibroids
  • Pelvic Inflammatory Disease

Pelvic veins can often be seen by Duplex Doppler ultrasound. This is a noninvasive test that looks at the flow of blood. It is similar to having a scan done when one is pregnant and involves placing gel on the thighs and lower abdomen and scanning. It is not painful and has no risk of radiation.

Most of the time, the diagnosis needs to confirmed by a CT Venogram (CAT scan) or MR Venogram. This is slightly more invasive in that a drip must be put up and a dye injected in order to create a vein map, so that treatment can be planned.

Treatment

The treatment of PCOS usually involves a surgical intervention called: Ovarian Vein Embolisation