Pelvic 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.
