Pelvic Congestion Syndrome (PCS) Overview

Pelvic congestion syndrome (PCS) affects women causing a chronic dull pelvic pain and a feeling of pressure and heaviness in the groin. PCS is often associated with varicose veins in the lower abdomen, groin, and ovaries. This condition tends to affect women aged 20 – 45 with a history of two or more pregnancies but can affect women with no history of pregnancy.

Pelvic Congestion Syndrome Causes

The cause for PCS is an increase in pressure in the veins in the pelvic region. The blood in the pelvic venous system is unable to drain properly and the pooling blood causes an increase in pressure to occur, resulting in pelvic pain.

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Pelvic Congestion Syndrome Risk Factors & Symptoms

Risk Factors for PCS include:

Multiple pregnancies
Multiple birth pregnancies
Age
Family History
Obesity

Symptoms for Pelvic Congestion Syndrome can impact the quality of a woman’s life on many levels, both physically and mentally.

Symptoms:

Chronic pelvic pain & pressure for more than six months
Discomfort with menstrual cycle
Pelvic pain during/after intercourse
Feeling of fullness or pain in the pelvic, vaginal, labia or perineal area
Swelling in the vagina, labia, or perineal area
The presence of varicose veins in the upper thigh, vagina, labia, or perineal area
Frequent urination
Incontinence

Pelvic Congestion Syndrome Diagnosis

A patient experiencing symptoms is the first indication that there is the possibility of PCS. The formal steps in the process of diagnosis would be:

An in-depth history and physical of the patient ruling out any other medical issues
Undergoing a transabdominal ultrasound evaluating for ovarian vein dilation
An intravascular ultrasound scan (IVUS) to assess and check the blood flow in the vessels
A venogram where a dye is injected into the veins to observe abnormal flow within the ovarian veins

Pelvic Congestion Syndrome Treatment

A patient would begin with the most minimally invasive treatment option, which is compression hose or shorts. If the wearing of these items does not alleviate the symptoms of pain/pressure, then the next steps would be endovascular diagnosis and therapy. A venogram is performed, under sedation anesthesia, where the pelvic veins are visualized. If the ovarian vein is dilated with abnormal flow called reflux, then an embolization procedure would be completed. This essentially blocks the vein with a coil, a small metallic device, which reduces pressure and pain symptoms. In the outpatient surgical setting, minimally invasive endovascular procedures can be performed with excellent outcomes for the patient. The benefits include:

No overnight hospital stay, patient can go home the same day
No incisions, the procedure is completed with a needle puncture groin access
Pain is minimal versus an open surgery
Rates of complication and scarring are decreased
Improved PCS symptoms of chronic pelvic pain

Pelvic Congestion Syndrome Prevention

While you cannot control what happens to the body, a patient knowing that they may be at a higher risk can take measures to avoid further difficulties.

Wearing compression hose during pregnancy
Maintaining a healthy weight and BMI during pregnancy
Maintaining a healthy BMI overall
Making compression hose part of your daily attire

Pelvic Congestion Syndrome Progression

The main symptom to be aware of is pelvic pain lasting for more than 6 months, often starting during pregnancy or after pregnancy, that also continues to worsen over time.

FAQs

Do hysterectomies solve Pelvic Congestion Syndrome?

During a hysterectomy, the periuterine veins are removed, which are the offending veins causing the issue of PCS.

What does Pelvic Congestion Syndrome feel like to patients?

Typically pain and pressure worsen over time; frequent bladder infections, painful intercourse, and painful periods are some of the issues facing patients.

How do you relieve pelvic congestion?

PCS is a chronic condition that requires a medical diagnosis where an endovascular procedure can relieve symptoms.

How common is Pelvic Congestion Syndrome?

PCS is a condition often underdiagnosed affecting women between the ages of 20 and 50 who have had multiple pregnancies. It is estimated to affect around 15% of the US population.

Pelvic Congestion Syndrome (PCS) Overview

Pelvic Congestion Syndrome (PCS) Overview

Pelvic Congestion Syndrome Causes

Pelvic Congestion Syndrome Risk Factors & Symptoms

Risk Factors for PCS include:

Symptoms:

Pelvic Congestion Syndrome Diagnosis

Pelvic Congestion Syndrome Treatment

Pelvic Congestion Syndrome Prevention

Pelvic Congestion Syndrome Progression

FAQs

You have a choice when it comes to vascular care. Get an appointment at VIC in 3 to 5 days - without a referral!

You have a choice when it comes to vascular care. Get an appointment at VIC in 3 to 5 days - without a referral!

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