Pelvic Congestion Syndrome
What is pelvic congestion syndrome?
Pelvic Congestion SyndromePelvic congestion syndrome (PCS) is caused by varicose veins in and around the pelvic organs and therefore the symptoms include the uterus, vagina, bladder and bowel. Some patient can develop pelvic varicose veins due to compression of the left renal vein (nutcracker syndrome) or from compression of the iliac veins causing blood to flow through the pelvis to get around the obstruction. Patients with other pelvic pathology like uterine fibroids, ovarian cysts have an increased risk of developing pelvic congestion syndrome. These conditions require more arterial blood flow and thus creates increase venous flow in the pelvis. During pregnancy increased pressure is put on the iliac veins and ovarian veins. Because of the inceased venous pressure the valves in veins to stop working and allow the blood to flow backwards, pool, and create varicose veins in the pelvic region. Some studies show that 30% of patients with chronic pelvic pain have pelvic venous insufficiency. Risk factors for developing pelvic insufficiency include multiple pregnancies, polycystic ovarian disease, fullness of the leg veins, and hormonal dysfunction. Pelvic congestion syndrome most commonly occurs in young women , and usually in women who have had at least 2-3 children. However, in men it presents with a varicocele or varicose vein next to the testicle.
What are the symptoms?
Symptoms of Pelvic Congestion SyndromePain during or just after having sex is one of the most common symptoms of pelvic congestion syndrome. Irritible bowel and irritible bladder, hip pain and fullness in the pelvis are other symptoms. There may be visible varicose veins in the groin area, buttocks, or upper thigh. The symptoms also tend to get worse at the end of the day and are somewhat relieved by lying down.
Pelvic PainWomen with PVI usually complain of a dull aching and heaviness in the pelvis that increases when standing, during pregnancy, and during menstruation. Sometimes this pain may be experienced in the lower back.
Other symptoms may include:
- Pelvic pain
- Abnormal vaginal bleeding
- Clear or watery discharge from the vagina
- Abdominal bloating
How are they treated?
Quick, effective outpatient visits treat the root cause, not just the symptoms.
DiagnosisWe treat vein issues using a stepwise approach. We start by identifying the problem with an ultrasound study of the legs. Once the bad veins are identified, we discuss the various treatment options and tell you which ones we think are the best for you.
TreatmentPVI is often treated with non-steroidal anti-inflammatory drugs. If that is insufficient, sclerotherapy or embolization of the vein may be used to block blood flow to the varicose veins.
The Vein Center of Arizona offers patients a wide variety of treatment options:
Comprehensive Treatment Plan
Developing a comprehensive treatment plan requires a thorough assessment. The assessment will normally consist of a review of your venous symptoms, a visual inspection of your problems and a thorough review of your venous history. The assessment completed by Dr. Paul Larson includes a very specific venous ultrasound performed by a registered vascular sonographer. Dr. Larson uses this diagnostic information to form a treatment plan.
Before seeking out a surgical or non-surgical treatment for varicose veins and other uncomfortable vein disorders, doctors may recommend conservative management techniques for patients. Conservative treatments may be required by an insurance company before other treatments can be considered.
Radiofrequency Ablation (RFA)
Radiofrequency ablation (or RFA) is a procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.
Endovenous Laser Treatment
Endovenous Laser Treatment for the elimination of unhealthy varicose veins is the gold-standard for minimally invasive treatment of varicose veins. EVLT uses laser energy, which is a highly concentrated beam of light. They work by delivering this light energy to the tissue that is targeted with extreme precision, so as not to damage the surrounding tissue.
Sclerotherapy is the primary treatment for spider veins and small superficial varicose veins that usually appear on the legs. They less commonly appear on other parts of the body. Sclerotherapy involves the injection of a chemical solution into a targeted spider vein or a reticular vein through a very fine needle.
Foam sclerotherapy is a minimally invasive technique for men and women to eliminate unsightly varicose veins and spider veins. The procedure involves injecting a foam sclerosant in a blood vessel to close it. The blood reroutes itself through healthy veins, restoring more normal blood flow.
Also known as ambulatory phlebectomy, this is a procedure that can be performed in the office and is commonly performed at the time of endovenous ablation. The procedure is intended to remove larger bulging varicose veins near the skin surface.