Pelvic Congestion Syndrome (PCS)

PCS and Embolization

pelvic-congestion-syndromepelvic-congestion-syndromePelvic Congestion Syndrome (PCS) is a chronic condition that affects as many as 15% of all women 18 to 50 years of age, and accounts for up to 40% of all gynecology office visits. The condition occurs in women when varicose veins form below the abdomen within the pelvic region.

Your pelvic pain is considered chronic if it lasts for at least six months.

While there are many causes of chronic pelvic pain, NYC Surgical Associates focuses on pelvic venous insufficiency. This condition is related to problems with the veins and circulation in the ovaries, particularly overly enlarged veins. You might think of it as varicose veins of the ovaries.

The cause of pelvic venous insufficiency is often unknown. It could be related to a physical issue, such as the positioning of the uterus, inflammation, or previous deep vein thrombosis of the pelvis. Hormones are likely also involved, since the condition is more common in premenopausal women. It is also more common in women who have had more than one baby.

Pelvic venous insufficiency often goes undiagnosed. Some physicians may not understand the condition, or they mistakenly think there’s no treatment, and no point in a diagnosis. However, our physicians can provide a treatment that may relieve your pain.

Pelvic Congestion Symptoms

The symptoms of pelvic congestion often include continual pain and discomfort in your pelvis. This could feel like a dull ache, particularly if you’ve been standing for a long time, after sex, before your period, and when pregnant. The pain is usually worse on one side. You may also feel a sense of fullness in your legs and bladder, as well as:

  • Pain in your lower back
  • Irritable bladder
  • Bloating
  • Nausea
  • Abdominal cramping
  • Enlarged veins on buttocks, thighs or vulva

Diagnosing Pelvic Congestion

If you are experiencing pelvic congestion-like symptoms, inform your physician. They may perform a number of tests to determine if chronic pelvic congestion is the source of your pain.

A venogram of the pelvic area is considered the gold standard for testing chronic pelvic congestion conditions. Venograms are minimally invasive, nearly painless, and performed through an IV.

Who is at Risk for Chronic Pelvic Congestion?

If you have had hormonal issues related to pregnancy or if you have been pregnant multiple times, you may be at higher risk for this condition. Varicose veins in other places on your body, continuing hormone issues or polycystic ovaries are also factors that may put you at risk for pelvic congestion. Genetic factors play a significant
role as well.

Pelvic Congestion Treatment

Non Surgical

For patients who have been diagnosed with pelvic congestion issues, some medications may provide relief from pain. Certain forms of birth control have proven useful in mild to moderate cases.

Surgical

Surgical treatment for PCS includes a procedure that ties-off veins in the affected area to relieve pressure and pain.  This route is much more invasive, and has a higher recurrence, risk than Ovarian Vein Embolization.

Ovarian Vein Embolization

For most patients with moderate to severe pelvic congestion, Ovarian Vein Embolization offers offer a safe, non-surgical treatment.

Ovarian vein embolization is an outpatient procedure performed under local anesthesia. Treatment is conducted via a catheter inserted through a small nick in the groin or neck to the ovarian vein using continuous x-ray imaging. The physician inserts small coils to block some of the blood flow, reducing the pressure in the vein and redirecting the blood to healthier pathways.

Patients are observed in the office 2 to 3 hours after the procedure, and most resume normal daily activities within 48 hours.

Embolization is very effective in the treatment of pelvic venous insufficiency : reports from peer-reviewed literature have shown a success rate of 95% to 100%. In addition, 83% of patients reported significant improvement in their symptoms. It is important to note that although the veins we treat are unlikely to come back, in some cases other pelvic veins may require additional treatment in the future.

OVE is minimally invasive and requires an incision of less than 3mm. Your surgeon will insert a catheter with miniaturized instruments that travel through your veins to the site of the problem. Your surgeon will then use extremely small particles or a small device to seal off the offending veins and eliminate the issue at its source. This can provide you with real relief from pain and can ensure that you experience the best possible results from your OVE procedure.

More About Ovarian Vein Embolization

Chronic pelvic congestion syndrome is a serious condition that affects an estimated 10 million women worldwide and is the second most common cause for ongoing pelvic pain. Many studies have shown that this pain is most likely caused by veins that pool blood in the pelvic region. This is similar to how varicose veins pool blood in the legs.

Ovarian vein embolization is the most effective treatment for chronic pelvic pain. A study published in the Journal of Vascular and Interventional Radiology in 2000 established the effectiveness of OVE in reducing or eliminating pain associated with chronic pelvic congestion syndrome. Here are some facts you should know about chronic pelvic pain and OVE procedures.

How Long is Recovery?

Most patients can leave the recovery room immediately after the procedure. Cramps are common after OVE and can last for a few days, with the first 24 hours generally being the most severe. Depending on your overall state of health, you should be able to return to normal activities and work the following day and should see significant reductions in pelvic congestion pain in as little as three days after OVE.

New York and New Jersey Pelvic Congestion Treatment

NYC Surgical Associates provides world-class treatment for a wide range of venous conditions, including PCS. We offer expert care and the most effective solutions for your medical issues. Call us today at 888-286-6600 to set up your initial appointment and to begin your journey to wellness now.

Additional Pelvic Pain Information

The Doctors

CBS News

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