Pelvic Congestion Syndrome is a chronic condition that affects women and is caused by varicose veins in the lower abdomen or pelvis. Valves in the veins become weakened and do not close properly. As a result, blood begins to flow backwards and pools in the pelvic veins and also the connecting veins to the legs.

SYMPTOMS

• An aching pain with heaviness in the pelvis that may extend to the lower back.
• Pain during intercourse
• Heavy menstrual bleeding
• Heaviness and swelling in their legs, especially on standing for long periods.
• Recurrent varicose veins

CAUSES/RISK FACTORS

This condition typically affects women 20-50 years old who have had previous pregnancies.

• Primary PCS
  • Believed to be idiopathic in nature
  • But women who have delivered 2 or more children are at increased risk
  • Proposed aetiology – recurrent dilatation of pelvic adnexial veins/ ovarian veins to accommodate increase in blood volume during pregnancy
• Secondary PCS
  • Due to associated Renal Nutcracker Syndrome
  • Compression of left renal vein by overlying SMA, resulting in elevated pressure and hence incompetence and backflow (reflux) down the left ovarian vein into pelvic adnexial veins
  • Due to associated Iliac Vein Compression Syndrome (May-Thurner Syndrome)
  • Compression of the (left) common iliac vein by the overlying right iliac artery resulting in reflux back down the internal iliac veins into pelvic veins

DIAGNOSIS

• CT scan of the abdomen and pelvis
• Pelvic venogram – a procedure that is performed by inserting a catheter through the groin vein and injecting a contrast agent (a type of dye) into the veins of the pelvic organs.

OUR TREATMENT

Ovarian Vein Embolisation

• Involves inserting a thin catheter into the femoral vein in your groin. The catheter is guided to the affected vein with the assistance of fluoroscopy, a type of x-ray technology. Tiny titanium coils with a sclerosing agent (also used for varicose veins) are inserted through the catheter to close off the affected vein(s).
• In most cases this is done as a day surgery procedure, allowing patients to be discharged on the same day of the procedure.

Click here to download our Pelvic Congestion Syndrome brochure

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