Therapy for Pelvic Congestion Syndrome

Pelvic congestion syndrome (PCS) is a disorder defined by the painful presence of abnormally blood-filled (varicose) veins in the pelvis. It afflicts as many as 15 percent of women between the ages of 20 and 50 and is a common source of undiagnosed pelvic discomfort. Therapy options for PCS include minimally invasive methods to deprive varicose veins of their blood supply, prolonged use of medication and surgery.

The Importance of Proper Diagnosis

• If you experience an aching, dull pain in your lower abdomen or lower back that worsens during menstruation or after intercourse, you may have pelvic congestion syndrome. Your pain may also worsen if you stand for long amounts of time or become significantly fatigued. Additionally, you may also suffer from varicose veins in other parts of your body, and will probably have been pregnant at least once. See your doctor if you suspect the presence of PCS, but be aware that proper assessment of your condition may take some time. Because of the relatively common nature of PCS symptoms, misdiagnosis frequently occurs, and when other potential sources of problems such as infection and cancer are eliminated your doctor may make no definitive diagnosis at all. To avoid or limit confusion, consider seeking out a physician who has previous experience in treating PCS.

Vein Embolization

• Once your condition is preliminarily diagnosed, you will undergo a two-part treatment known as vein embolization. In the first phase of treatment, a catheter will be inserted in veins commonly involved in PCS and a special dye will be injected to highlight any varicose conditions. These veins will then be mapped out for the next phase of treatment.

  After an amount of time sufficient to allow you to recover from the first procedure, you will undergo a second catheterization. This time, after the application of a local anesthetic combined with intravenous sedation, your surgeon will insert specially-designed blocking coils into your varicose veins, followed by a substance that encourages the veins to close down around the coils. In combination, these materials effectively stop additional blood from entering the affected veins. Without this blood flow, pressure in the veins will diminish, providing gradual relief from symptoms.

Potential Outcomes and Additional Treatments

• Both phases of vein embolization typically require overnight stays in the hospital along with temporary use of medications to treat postoperative pain. Once you have recovered from embolization, you will probably be part of the 85 to 95 percent of women who experience at least some permanent reduction of pelvic pain. If your pain is not significantly reduced, you may be treated through continued use of painkillers or hormone therapy designed to diminish the heavy blood flow associated with menstruation.

  If your pain is particularly severe, you and your doctor may consider more-radical treatment options including surgical removal of the affected veins and hysterectomy. Consult your doctor for complete guidelines of any treatment she may recommend.