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What is Pelvic Congestion Syndrome?

Posted on September 10, 2023

Pelvic Congestion Syndrome, (PCS, a condition also referred to as ovarian vein reflux) is a leading cause of pelvic pain, as well as incontinence. Now, these symptoms are also signs of uterine fibroids. But, with PCS, the symptoms aren’t the result of non-cancerous uterus tumors. Instead, they’re the result of varicose veins deep within your pelvis and lower abdomen.

For most women, the malfunctioning veins are located in the ovaries. And they form because of vein reflux, a condition in which blood flows backward in the veins, causing it to pool and stretch the vein walls. When that happens, women may experience a chronic pelvic ache, or a sensation similar to a pull or tug in the pelvis.

The Trouble with Identifying PCS Symptoms

In addition to pelvic pain, women with Pelvic Congestion Syndrome may experience, bowel and bladder issues, as well as pain with intercourse. Plus, if you have this condition, you may be able to see varicose veins in or near your vagina, vulva, anus, and/or perineum.

The British Society of Interventional Radiology reveals that PCS is responsible for chronic pelvic pain in up to 40% of women. Sadly, it’s hard to get a proper diagnosis, as many doctors believe the symptoms are a sign of endometriosis or other pelvic conditions. Want to avoid a delayed diagnosis and receive prompt and appropriate treatment? Here’s what you need to know.

Understanding Pelvic Congestion Syndrome

PCS develops when excessive amounts of blood pool in your pelvis. Often, varicose veins deep within your body are to blame for this pooling. And, while both genders can be affected, women are more likely than men to deal with PCS.

Now, it’s easier to diagnose men, because half of their four pelvic veins are visible from the skin’s surface. But, women’s pelvic veins are all buried deep beneath the skin’s surface, making it harder to diagnose their PCS. As such, it’s important to know your risk factors for the condition, including a previous pregnancy, in order to get a prompt diagnosis.

Also, your age matters with this condition, as PCS mostly impacts premenopausal women. However, menopause often doesn’t relieve this condition. And, in some cases, women won’t even develop pelvic congestion syndrome until after menopause, suggesting we have much to learn about its root causes.

Why does pelvic congestion syndrome cause disruptive symptoms? A woman laying on a couch with her stomach hurting.

PCS is tied to varicose veins in the pelvis. And they develop when valves fail, allowing blood to build up in the pelvic instead of being pushed up and out to your heart. As a result, they dilate, putting pressure on the pelvis and your pelvic floor muscles.

We still don’t know why those valves fail. But we do know it’s more likely to happen if you’ve been pregnant at least once. Now, that could be because the pressure of a growing fetus could injure your veins, especially late in your pregnancy. Or, it could be because excess estrogen causes those veins to widen. Then, in some cases, the condition develops as a side effect of May-Thurner syndrome. The why matters less than the results, which leaves most women with the same characteristic symptoms.

The Right Way to Identify PCS

PCS causes deep pelvic or uterine pain that’s usually dull and aching. That pain gets worse throughout the day, especially with exercise, postural changes, or heavy lifting. Monthly periods and sexual intercourse can also cause symptoms to worsen.

In addition to pelvic pain, pelvic congestion syndrome can lead to frequent urination and incontinence, likely due to increased volume of the pelvic veins. Finally, many people with PCS also suffer from Irritable Bowel Syndrome (IBS), chronic fatigue or back pain.

Treating PCS in Dallas TX

After diagnosing PCS via ultrasound, we can treat the condition with Pelvic Vein Embolisation, or PVE. Recently, the Society of Vascular Surgeons endorsed this treatment option—which is similar to UFE—as a great treatment for Pelvic Congestion Syndrome.

Before beginning PVE, you’ll receive a local anesthetic. Then, we’ll insert an ultrasound-guided catheter into your damaged pelvic vein. Next, we place embolizing material that permanently blocks the vein, relieving PCS symptoms and preventing their return, since the vein will shrink after this procedure.

Ready to find relief from the aching, dull pain of PCS? Schedule a consultation with our interventional radiologists in Dallas, TX. With the right diagnosis and treatment plan, we can help you put chronic pelvic pain in your past, exactly where it belongs.

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