It is estimated that nearly a third of all women experience chronic pelvic pain during their lifetime. Chronic pelvic pain or pelvic congestion syndrome is defined as pain lasting greater than six months.
The condition is notoriously difficult to diagnose because of the absence of any visible abnormalities on routine tests. In the most common situation, a woman experiencing symptoms consistent with pelvic congestion syndrome will have seen several specialists before arriving at a diagnosis. Clearly, a complete evaluation by a gynecologist is primary. Some general clues include chronic pelvic pain that is worse when sitting or standing (similar to varicose veins), relieved with lying down, and the presence of vulvar varicose veins.
The causes of pelvic congestion syndrome
Primary disease is secondary to varicosities in the pelvic and ovarian veins. This is more common with multiparous women, obesity, and genetic
Secondary conditions such as Nutcracker syndrome, May-Thurner Syndrome, and other obstructing syndromes
Chronic pelvic pain caused by reflux or obstruction of the gonadal, gluteal, or periuterine veins is called pelvic congestion syndrome. Incompetent venous valves in the pelvic veins can lead to reflux and development of pelvic varices. These dilated veins may sometimes be seen with ultrasound, CT, or MRI. These enlarged and abnormal veins are more common on the left, more likely in women who have had multiple pregnancies, and very similar in cause to lower extremity varicose veins.
Pelvic congestion syndrome treatment is divided into medical and procedural. Minimally-invasive techniques have supplanted traditional surgery and increased the use and success rates of the curative solutions.
The length of the procedure is generally 30 minutes to several hours depending on the complexity of the condition and skill of the pelvic congestion syndrome doctors near me.
Pros and Cons of Treatment
Pros
- High Success rates with coil embolization for treatment
- Minimally invasive procedure with same day discharge. Reduced risks of complications vs traditional surgery
- There is no need for sutures post procedure
- General anesthesia is not required
Cons
- Contrast material should be used cautiously in patients with renal disease
- Contrast material has a small risk of allergic reactions
- Risks of bleeding, infection or damge to the vein are rare but possible complications.