Women with pelvic congestion syndrome are typically less than 45 years old and in their childbearing years. Ovarian veins increase in size related to previous pregnancies. Pelvic congestion syndrome is unusual in women who have not been pregnant.
Chronic pelvic pain accounts for 15% of outpatient gynecologic visits. Studies show 30% of patients with chronic pelvic pain have pelvic congestion syndrome (PCS) as a sole cause of their pain and an additional 15% have PCS along with another pelvic pathology.
The chronic pain that is associated with this disease is usually dull and aching. The pain is usually felt in the lower abdomen and lower back. The pain often increases during the following times:
- Following intercourse.
- Menstrual periods.
- When tired or when standing (worse at end of the day).
Other symptoms include:
- Irritable bladder.
- Abnormal menstrual bleeding.
- Vaginal discharge.
- Varicose veins on vulva, buttocks, or thigh.
Once a diagnosis is made, if the patient is symptomatic, an embolization should be done. Embolization is a minimally invasive procedure performed by interventional radiologists using imaging for guidance. During the outpatient procedure, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the femoral vein in the groin and guides it to the affected vein using X-ray guidance. To seal the faulty, enlarged vein and relieve painful pressure, an interventional radiologist inserts tiny coils often with a sclerosing agent (the same type of material used to treat varicose veins) to close the vein. After treatment, patients can return to normal activities immediately.