Pelvic Congestion Syndrome
For decades, millions of women – more than a third of the female population – have suffered with undiagnosed pelvic pain, perplexing physicians and leaving patients with few options. During the last 10 years, specialists have discovered the cause may be hard-to-detect varicose veins in the pelvis, known as pelvic congestion syndrome.
Pelvic congestion syndrome is similar to varicose veins in the legs, a condition caused by malfunctioning valves that do not close properly and allow blood to flow backwards and pool in the veins rather than travel to the heart. The accumulation of blood puts pressure on the veins and causes them to bulge. Varicose veins often cause pain, and in the pelvis, may affect the uterus, ovaries and vulva.
Diagnosing the condition has been difficult because when a woman lies down for a pelvic exam, the pressure on the veins is reduced and they do not appear to bulge as they do when she is standing. Women with this syndrome will typically feel worsening pain through the day when standing.
Surgery may be done to address the condition but it typically involves a hysterectomy along with tying off or removing the veins. Hormone treatment, in the form of birth control, may also be used to decrease symptoms.
Holy Name Medical Center’s Interventional Radiologists can perform a minimally invasive treatment that has been shown to successfully treat pelvic congestion syndrome.
- Age – women with this condition are typically 45 years old.
- Number of pregnancies – ovarian veins increase in size with each pregnancy. Women who have never been pregnant do not usually have pelvic congestion syndrome.
- Fullness of leg veins – the same conditions that cause varicose veins in the legs may lead to varicose veins in the pelvis.
- Polycystic ovaries
- Hormonal dysfunction
- Dull, aching pain in the lower abdomen and lower back
- Pain that increases after intercourse, menstrual periods, when tired or when standing and during pregnancy
- Irritable bladder
- Abnormal menstrual bleeding
- Varicose veins on the vulva, buttocks or thighs
Pelvic congestion syndrome can be diagnosed by an interventional radiologist through several minimally invasive screenings.
Pelvic venography is considered the most accurate method for diagnosing the condition. A contract dye is injected into the veins of the pelvic organs and an X-ray is taken while the patient is on an incline.
An MRI is the most non-invasive method of pelvic congestion syndrome but it needs to be adapted to look specifically at pelvic blood vessels.
Pelvic and transvaginal ultrasounds are not very effective in diagnosing the condition but they may be used to rule out other pelvic disorders.
An embolization is the most effective treatment for pelvic congestive syndrome. Using X-rays for guidance, an interventional radiologist inserts a thin catheter into the femoral vein in the groin and guides it to the affected vein. A drug is injected through the catheter that causes the vessel to shrink and eventually dissolve, forcing the blood to be rerouted through other veins. The procedure is successful in eliminating or diminishing symptoms in 85 to 95 percent of patients and may be repeated if necessary. Patients are able to resume daily activities almost immediately.