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What Is Pelvic Congestion Syndrome?

by Dr Rakesh Wahi MD

At the Center for Vascular Medicine in Greenbelt, Maryland, Dr. Rakesh Wahi, MD, and his colleagues see patients with the full spectrum of vascular diseases. Area physicians sometimes send patients with chronic pelvic pain to Dr. Rakesh Wahi, MD, to check for vascular problems after gynecological, urinary, or intestinal issues are ruled out.
One vascular cause of chronic pelvic pain could be pelvic congestion syndrome, which is essentially varicose veins in the pelvis. The condition is similar to varicose veins in the legs, as the valves that help return blood to the heart do not work properly. As a result, the veins weaken, dilate, and pool up with blood, causing pain and pressure in the pelvic area.
The pain may range from a dull ache to a throbbing sensation and is often worse after a long day of sitting or standing. Lying down often provides relief. The condition typically strikes women in their childbearing years who have experienced at least two pregnancies. Having varicose veins of the legs or polycystic ovarian disease are other risk factors.
Pelvic congestion syndrome can sometimes be diagnosed with an ultrasound, but a pelvic venography, in which contrast dye is injected in the veins to obtain a better view on X-ray, is a more accurate diagnostic tool.
Embolization is the treatment of choice for this condition and is performed by threading a catheter from a vein in the groin to the affected pelvic vein. Using X-ray guidance, tiny coils are then fed through the catheter to block blood supply to the treatment area. A sclerosing agent is often used at the same time to close the vein. About 80 percent of patients report a reduction in pain after the procedure.                             
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