Pelvic congestion syndrome (PCS) is a condition in which varicose veins occur in a woman’s pelvic region, around the ovaries. Similar to varicose veins in the legs, the valves in the pelvic veins no longer function normally, so blood backs up and they become engorged or “congested,” which can be extremely painful.
In men, a similar condition can cause varicose veins to form on the scrotum, which is known as a varicocele. In women, however, these varicose veins are internal, which is one reason why PCS is often missed and may go undiagnosed.
In fact, the diagnosis of pelvic congestion syndrome is seldom obvious and can only be made after ruling out other disorders—such as endometriosis, fibroids and uterine prolapse—that cause pelvic pain and may have the same symptoms as PCS.
At Cooper University Health Care, however, our vascular and endovascular surgeons work closely with gynecologists (doctors who specialize in women’s reproductive health) to accurately recognize and effectively treat pelvic congestion syndrome as quickly as possible.
Why Choose Cooper to Treat Pelvic Congestion Syndrome?
Our vascular and endovascular surgeons have extensive experience in diagnosing and treating pelvic congestion syndrome, and we are able to determine the most appropriate approach for your individual situation.
Key features of our program include:
- A collaborative approach to diagnosis: Cooper’s vascular surgeons work in collaboration with your gynecologist; once you undergo a complete evaluation by your gynecologist to rule out other causes of pelvic pain, a referral to one of our vascular surgeons is the next step. You may ask your gynecologist for a referral to our office or contact us and we will obtain the referral for you.
- Sophisticated testing: Our physicians use advanced diagnostic imaging to determine if you have pelvic congestion syndrome. These tests may include:
- Ultrasound: This is the first test of choice for assessing the uterus and other organs in the pelvis; it helps visualize blood flow and assess the presence of varicose veins in the pelvis
- CT scan: A CT scan can look at the entire anatomy of the lower pelvis and identify varicosity of the pelvic veins; an intravenous contrast dye may be used to enhance the images
- Magnetic resonance imaging (MRI): This is a useful test in diagnosing pelvic congestion syndrome because it doesn’t use radiation or contrast dye
- Venogram: This test involves injecting a dye into one of the veins in the groin and obtaining x-rays
- Advanced treatment: Once diagnosed, pelvic congestion syndrome can be effectively treated without surgery:
- Embolization is a safe, effective and minimally invasive outpatient catheter procedure in which the physician inserts tiny coils into the enlarged vein, often with a sclerosing agent (the same substance used to treat leg varicose veins), to seal and close the vein. Patients typically return to work and light activities the following day. Up to 95% of women experience improvement in their symptoms after embolization.
- Hormonal medications are another treatment for PCS that can reduce blood flow and congestion of the varicose veins to relieve pelvic pain
Pelvic Congestion Syndrome Risk Factors
The women who are most at risk of developing pelvic congestion syndrome share one or more of these characteristics:
- Are in their childbearing years, between the ages of 20 and 45
- Have had multiple pregnancies
- Have experienced hormonal increases
- Have hormonal dysfunction
- Have polycystic ovaries
- Experience fullness of veins in legs
Pelvic Congestion Syndrome Symptoms
Pelvic pain is the number one complaint in women with PCS. This pain may occur:
- At the end of the day
- After prolonged standing
- Just before the onset of the menstrual cycle
- During or just after intercourse
- During later stages of pregnancy
Notably, women may feel pelvic pain while standing but not when lying down. This can sometimes make diagnosis difficult because women are usually asked to lie down for a pelvic exam, relieving the painful pressure that brought them to the doctor.
Other symptoms that may indicate PCS include:
- Irritable bladder
- Varicose veins on vulva, buttocks and/or legs
- Swollen vulva/vagina
- Abnormal menstrual bleeding
- Tenderness to touch in lower abdomen
- Painful menstrual periods
- Vaginal discharge
- General lethargy
- Feelings of depression
To learn more about the services available in the Division of Vascular and Endovascular Surgery or to schedule an appointment, please call 856.342.2151.
Refer a Patient
If you are a doctor who wants to refer a patient to the Division of Vascular and Endovascular Surgery, please call 856.968.7067.