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