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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.


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  • 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.

  • 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


  • 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.



Click here to download our Pelvic Congestion Syndrome brochure

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