Pelvic Congestion Syndrome

Pelvic Congestion Syndrome is pelvic discomfort associated with abnormal veins in the pelvis.  During pregnancy, these veins often become dilated with the increased blood volume and hormonal changes.  This can lead to changes in the veins that persist after pregnancy.

When the veins become dilated, the valves can fail and blood starts to pool in the pelvic area. Some women may notice bulging veins on or around the vaginal labia. These are much like varicose veins on the legs, but internally they can cause many symptoms, including:

• Pain in the pelvis or lower back
• Varicose veins around the vulva and inner thighs
• Irritable bladder with sudden urges to urinate
• Overly painful menstrual cycles
• Pain during or after intercourse

Several factors contribute to the development of PCS. The syndrome is more common after pregnancy, especially those who have had several pregnancies. Symptoms tend to worsen with each pregnancy.

Estrogen also causes veins to dilate, so hormonal changes during pregnancy, during the menstrual cycle, and other fluctuations may trigger the condition or make the pain worse.

Your doctor will choose the best methods of evaluation and treatment for you after extensive consultation, examination, and testing. Different imaging methods may be used to evaluate the pelvic veins including ultrasound, CT, MRI, and venography. Ultrasound can be used to evaluate varicose veins dropping from the groin or buttocks into the legs.

Most abnormal pelvic veins are treated with minimally invasive techniques.  That means that a small catheter is inserted in a leg vein and advanced up into the pelvic venous system to the vein in question. Abnormal veins can then be closed down using various techniques including coil embolization and foam sclerotherapy.,

Veins that have dropped from the groin or buttocks into the legs are treated with the same techniques as other leg varicose veins.

If you have pelvic pain caused by PCS, you may be a good candidate for treatment. Only a full consultation and examination, can determine whether you have PCS and the best way to treat it. We often coordinate the workup and treatments with other medical providers such as interventional radiologists.

With treatment, you should experience less pain in your pelvic area. Other symptoms, such as bladder urgency and sexual discomfort, may improve or resolve completely.

Treating the pelvic veins also decreases the risk of seeing varicose veins in the legs that have originated from the pelvic/crotch region.