Pelvic congestion syndrome (PCS) also known as ovarian vein reflux, is a chronic condition that causes pain in a patient’s lower abdomen/pelvis. When the valves of the ovarian veins in the pelvic area begin to function improperly, blood can start to pool in the pelvis. Over time, the veins can begin to enlarge and become varicose veins. Varicose veins have nonfunctional valves, and can cause blood to flow backwards and pool. This can lead to the development of pelvic congestion syndrome.
PCS most often affects women between the ages of 20 to 50 who have previously experienced pregnancy. The condition is relatively common, and approximately 15 percent of women in the United States will experience PCS in their lifetime.
Pelvic Congestion Syndrome can be hard to diagnose, as it can be difficult to differentiate between it, and other types of pelvic pain. Many different organ systems overlap within the pelvis including the digestive, urinary, and reproductive systems.This means a pain originating in any one of these systems could be the problem. Psychological disorders like depression and history of sexual abuse have also been linked to pelvic pain. Confirmed cases of PCS are more likely in women who have been pregnant more than once, and suffer from polycystic ovaries and hormonal dysfunction.
To test for PCS, a doctor will first have to conduct tests on all of these organ systems to rule out other conditions. This may include blood tests to check for STI’s, anemia and pregnancy; urine tests to ensure your urinary system is not the issue; a pelvic ultrasound. If those tests do not reveal a cause, a pelvic CT scan or MRI can evaluate for ovarian vein varicosities.
After that, the definitive way to confirm PCS is a diagnostic test called Pelvic Venography. This test will let a patient know if they have the varicose veins in the pelvic area that are associated with pelvic congestion syndrome.
The primary symptom of PCS is long term pelvic pain. If a pain in the lower abdomen lasts more than 6 months, it’s possible it could be PCS. The pain will most likely come during or after pregnancy, and become worse during any subsequent pregnancies.
The type of pain with PCS can vary, with some patients reporting a dull ache. Others have said the pain is more sharp, or focused on one particular side of the pelvis. Typically, symptoms follow a pattern of no pain in the morning after sleep then gradually increase over the course of the day while upright. When a PCS patient lies down, the symptoms get much better. The pain can worsen depending on certain actions, such as:
Other less common symptoms include the urge to urinate, enlarged veins on the thighs, buttocks, or genitals, and pain specifically before or during menstrual periods. Patients experiencing painful symptoms of PCS should begin to consider their treatment options.
Performed by an interventional radiologist, this vascular procedure involves the closure of malfunctioning veins within the pelvis to prevent further enlargement.
Ovarian Vein Embolization is an effective treatment for pelvic congestion syndrome. An OVE procedure can drastically relieve the pain caused by faulty pelvic veins, and make sure they are no longer enlarged with excess blood.