Around one-third of women will be affected by chronic pelvic pain at some point during their lifetime. There are many different causes of pelvic pain. A thorough physical examination is usually necessary to identify the cause in each case. One cause of chronic pelvic pain is pelvic congestion syndrome.
What is pelvic congestion syndrome?
Pelvic congestion syndrome is caused by varicose veins in and around the ovaries. Varicose veins most commonly develop in the legs and affect a significant proportion of middle-aged and older women. Varicose veins are caused by malfunctions of the valves that assist in returning the blood to the heart. When the valves malfunction, the blood pools in the vein, and it enlarges. Severe varicose veins can be very painful. When the veins around the ovaries become varicose, they can cause significant pelvic pain.
What causes pelvic congestion syndrome?
Pelvic congestion syndrome is thought to be caused by the same factors that lead to varicose veins in the legs. These factors include a genetic predisposition, standing for long periods at work, and pregnancy. Pregnancy seems to be particularly important in the etiology of pelvic congestion syndrome since it is virtually never seen in women who have not been pregnant.
How is pelvic congestion syndrome diagnosed?
Chronic pelvic pain that gets worse while sitting or standing, and is relieved by lying down, is very suggestive of the syndrome. Most women who develop varicose veins in the pelvis also have them in their legs, buttocks, and vaginal area. The final diagnosis is made during a minimally invasive transcatheter procedure. Under sedation and local anesthetic, a catheter is threaded into the veins through a tiny incision in the thigh. A dye is injected through the catheter to allow any varices to be visualized in a procedure called a venography. If any are identified, they can immediately be treated during the same procedure.
How is pelvic congestion syndrome treated?
If varices in the ovarian and pelvic veins are detected by venography, the varices can immediately be emoblized during the same procedure. Embolization can be performed by either injecting a chemical agent into the catheter or inserting a small heating coil through the catheter. The agent or coil damages the dilated vein, causing it to collapse and seal shut. An estimated 80% of women experience significant relief of their pelvic pain after an embolization procedure. Some women have so many pelvic varices that they need to undergo two or three procedures to treat them all.
What is the recovery like?
Most women are admitted to the hospital overnight after an embolization procedure, primarily to control post-procedure pain. There may be significant pain during the first three days after an embolization procedure, which can be controlled with medication. Most women can return to their normal activities within a week.
At STX Vein Institute, our medical team will work with you to create a treatment plan that is right for you. Our doctors specialize in laser conditions and treatments, and we can help you get the relief that you need. Contact STX Vein Institute today to schedule your consultation.