PELVIC CONGESTION SYNDROME AND CHRONIC PELVIC PAIN

The syndrome of pelvic congestion is a consists of a spectrum of abdominal and pelvic venous conditions that is associated with varicose veins in the pelvis. As with varicose veins in the legs, the valves in the pelvic veins can also give way allowing blood under pressure to stay in the pelvis rather than drain back to the heart. The source of this high venous pressure may be from either the veins draining the ovaries or the veins within the pelvis itself. This pooling of blood under pressure leads to dilated varicose veins in the pelvis, chiefly around the ovaries and the uterus causing congestion of the pelvic organs.

The condition is characterized by symptoms such as chronic pelvic pain, heavy irregular periods that may last for even two weeks, pelvic floor varicose veins, varicose veins in the groin or vulva and leg swelling. Pain on sitting or lying down felt as a constant ache somewhere deep in the pelvis and pain during intercourse or especially just after intercourse are typical. In severe PCS, there may even be blood in the urine. Whilst many gynecological conditions can mimic some of these symptoms, most women would have undergone extensive gynecological investigations and even treatment with little relief.

Many women who are suffering from the symptoms of pelvic venous disorders are not offered the appropriate clinical assessment and ultrasound investigation. It is often overlooked in routine pelvic scans and invasive diagnostic tests. At Harley Street Vascular Centre, our highly skilled vascular team follow a strict pelvic duplex ultrasound protocol and treatment guidelines as we strive to provide accurate and effective diagnostic and treatment services for our patients.

To see if you need a confidential assessment for Pelvic Congestion syndrome, run your PCS score here. A score of 3 or more needs a medical assessment by a physician. You may contact us to make an appointment.

• Ovarian vein embolization When the source of the high vein pressure in the pelvis is the veins draining the ovary, they can be stopped from transmitting that pressure by blocking them with coils using a key-hole technique. The procedure may need an overnight stay and can often be done under a local anesthetic with sedation. It is performed under the guidance of X-ray and special ultrasound catheters that can view the veins from inside the vessel (Intra vascular ultrasound)
• Iliac vein stenting This may be required when blockages in the veins draining the pelvis lead to venous hypertension and congestion in the veins around the uterus and in the pelvis. A metallic tube (stent) is placed within the blocked vein to relieve the blockage and allow venous drainage to take place normally. The procedure needs an overnight stay and usually a short general anesthetic. It is performed under the guidance of X-ray and special ultrasound catheters that can view the veins from inside the vessel (Intra vascular ultrasound)