Pelvic Congestion Syndrome

We all know about varicose veins in the legs, but did you know they can develop in the abdomen and pelvis too? They can, and when they do it results in chronic pelvic pain and develops into a medical condition called Pelvic Congestion Syndrome (PCS). The syndrome occurs mostly in women, although research is currently being done to understand whether pelvic pain in men is caused by PCS.

It is important to accurately diagnose and treat PCS because national studies show that nearly 30 percent of women in the US suffer from chronic pelvic pain. The doctors at USA Vascular Centers treat PCS with minimally invasive, in-office treatments that make it easier, and less painful, for women to find relief.

Our renowned vascular surgeons are also experts in fallopian tube recanalization, uterine fibroid embolization and pelvic congestion syndrome.
What you need to know about pelvic congestive syndrome


The pain is caused by swelling of the veins in the pelvis, underneath the abdomen. The veins become congested because of excess venous (of the veins) blood which is not exiting the pelvic area as it should. It really can be considered “varicose veins of the pelvis”.
Two long veins run down the back of the abdomen, coming from the kidneys and connecting with the ovaries. They work by taking blood from the ovaries and returning the blood to the heart. Valves in the veins keep the blood moving to the heart, against the pull of gravity. However if these valves don’t work properly, the blood pools and the veins become congested, just like they do in the legs. (There are two shorter veins as well, and these can also become varicose veins.)


How can the doctor tell if I have PCS?

There are several different ways to diagnose PCS. First, and most importantly, is the detail with which the woman can describe her symptoms. At USA Vascular Centers our physicians believe that it is very important to listen carefully to our patients. They are the most important source of information about their own bodies.
  • Doctors can test for PCS using a transvaginal duplex ultrasound scan. Our specialists have specific training with this diagnostic scan because it is the best way to see the varicose veins, small and large, in the pelvic area. It also shows which veins are swollen and which are not.
  • An external scan can also be conducted. The abdomen is scanned and the larger veins can be seen, although not as clearly as with a transvaginal duplex ultrasound.
  • A CT scan or MRI can also be used to detect varicose veins in the pelvis. However, these diagnostics are not as precise in seeing the smaller veins that may be involved.
USA Vascular treats women's vascular issues including fallopian tube recanalization, uterine fibroid embolization and pelvic congestion syndrome.


How do I know if my pain is from PCS?

The symptoms of Pelvic Congestion Syndrome can feel similar to the symptoms of endometriosis, uterine fibroids, or even uterine prolapse. Some of the symptoms become worse during menstruation, so it can be difficult to tell exactly what is causing the pain. In order to determine the specific cause, it is important to see a doctor and discuss your symptoms.

Symptoms can include:

  • Tiredness, lethargy, depression.
  • Abdominal bloating or tenderness in the abdominal area.
  • An irritable bladder or bowel.
  • Discomfort during sexual intercourse.
  • An unusual “aching” in the pelvis, particularly during menstruation, that feels worse when standing and better when lying down; abnormal menstrual bleeding or painful periods.
  • Chronic dull ache in the abdomen or back ache.
  • Swelling in the vagina or the vulva.
  • Visible varicose veins in the vulva, legs and/or buttocks.
  • Unusual vaginal discharge.


What are the risk factors for PCS?

A woman can be at higher risk for PCS if she has any of the following:

  • Two or more pregnancies with vaginal delivery.
  • A tipped uterus.
  • Varicose veins in the legs.
  • Polycystic Ovarian Syndrome.
  • Being overweight.
  • Is of reproductive age, generally considered to be between the ages 25 and 45.


Common PCS Questions

The physicians at USA Vascular Centers use a process call “embolization”. Our physicians use an x-ray or ultrasound to guide them as they thread a tiny, thin tube into the veins in the neck and then down into the vein to be treated. Then a tiny device is inserted into the vein through the tube, which causes the vein to be blocked permanently.
We will make sure that you are very comfortable during the procedure. It is done in our office, and we will give you a mild sedative to relax you. You will not be in pain during the procedure and you will go home when you are done. The minimally invasive techniques used by USA Vein Clinic doctors mean that you have a much shorter recovery time and a faster return to work and your lifestyle, than if you had had traditional surgery.

If you are suffering from any of the signs or symptoms of PCS schedule a consultation to talk with one of our doctors.

If you are suffering from PCS, a condition of the veins, then you want a highly trained vascular surgeon to take care of you. That is what we are here for. Call us today.

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