OVERVIEW
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.
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