What is Pelvic Congestion Syndrome?

When the veins in the pelvis (lower half of your belly) stop working well, blood may pool within them. This pooling of blood can cause the veins to grow abnormally large and irregular in shape. Large and irregular veins in the pelvis can result in chronic pelvic pain and/or discomfort.

Your doctor may order an ultrasound, CT or MRI of your pelvis because these large and irregular veins can be seen on these medical images.

Pelvic congestion syndrome (PCS) is a combination of chronic pelvic pain and large, irregular veins in the pelvis.

What are the signs and symptoms of Pelvic Congestion Syndrome?

Pelvic pain that:

• Lasts at least six months
• Is located on one side or both of the pelvis
• May be sharp or dull
• Could be constant or intermittent
• Extends to the external genitals (vulva) and thighs
• Feels worse at the end of the day, during your period, or during/after sexual intercourse
• Eases when you lay down
• Starts during or after pregnancy and worsens with each additional pregnancy

You may see large veins on:

• the buttocks
• external genitals (vulva)
• thighs

Who gets Pelvic Congestion Syndrome?

Many variables contribute to the development of pelvic congestion syndrome. This includes lifestyle, a family history of vein problems, and a history of multiple pregnancies. During pregnancy, there is increased blood flow to the pelvis, which can affect the veins. Hormones may also contribute to veins growing wider.

How is Pelvic Congestion Syndrome Treated?

Pelvic Vein Embolization (PVE) is a minimally invasive, non-surgical procedure used to treat pelvic congestion syndrome. This procedure safely reduces blood flow in the pelvis and helps to ease pain, thus improving your quality of life.

What should I do if I believe I have Pelvic Congestion Syndrome?

If you believe you are suffering from Pelvic Congestion Syndrome, talk to your primary physician and/or your Obstetrician/Gynecologist for a referral to an Interventional Radiologist. You can also contact the UHealth Interventional Radiology Department directly for recommendations on what to do next.

Tests

History and Physical Exam
Your doctor will ask about your symptoms and evaluate you for other potential causes of pelvic pain.

Imaging
A computed tomography (CT) angiogram or magnetic resonance (MR) angiogram of the pelvis creates images of the blood vessels in the pelvis using contrast dye.

Treatments

Some women may be able to conservatively manage their pain with Tylenol or non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen. However, if symptoms persist despite conservative management, you may benefit from a minimally invasive procedure: called pelvic venous embolization and or sclerotherapy.

During this procedure, an interventional radiologist will make a small incision in the femoral vein in your thigh. Then, utilizing image guidance, they place a thin tube or (catheter) through the abnormal veins in the pelvis.

Once the catheter is in place, they close off the abnormal veins by using a special solution that collapses them in addition to tiny coils, plugs or glue-like substances. 

Altogether, the procedure may take up to two hours depending on how many veins are treated. Most patients go home the same day and return to normal activities shortly after.

Over time, blood flow to the pelvis will be reduced resulting in a significant improvement or resolution of symptoms.

Why Choose UHealth?

Care designed with women in mind. The Department of Interventional Radiology at UHealth has experienced physicians offering care specific to women’s health issues. Our interventional radiologists work in collaboration with obstetricians and gynecologists as well as primary care physicians to provide research-backed care that is tailored to each woman. We help make care more convenient — offering advanced in-office procedures, the latest diagnostic tests for fast results, and access to comprehensive women’s health services for women of all ages — all in one location. Our highly-trained physicians and staff are sensitive to the needs of every woman, so you can feel comfortable and confident in your care and treatment.

Expert care from highly trained interventional radiologists. Our interventional radiologists and radiology specialists are experts in a variety of minimally invasive procedures — everything from treatments to clear blocked blood vessels to advanced cancer therapies like NanoKnife®.

Leading-edge imaging care in South Florida. Our doctors are also researchers discovering new ways to improve diagnosis and treatment. That means you can get some of today’s most promising advancements through clinical trials. You benefit from the latest developments that are fast-tracked from the lab to the bedside.