Pelvic Congestion Syndrome

Symptoms of Pelvic Congestion Syndrome

The pain associated with PCS presents as a dull ache or a sensation of heaviness in the pelvis. It can last 3 to 6 months and can be one or both sides of the pelvis with left side more frequently affected . However, the pain can switch from one side to the other. Any factor increasing the abdominal pressure (walking, postural changes, lifting, and longtime standing position) can increase the intensity of pain. It is often exacerbated before or during the menstrual period. The intensity of pain worsens with each subsequent pregnancy, and during or after sexual intercourse. The time of the day also affects the intensity with pain being worse at the end of the day.

This condition typically affects women in the age group of 20-50 years after multiple pregnancies. There are two types

• Primary PCS: no cause is found.
• Secondary PCS: due to compression of veins by adjacent blood vessels with congestion.

Diagnosis

• Clinical evaluation 
• CT scan of the abdomen and pelvis

Treatment 

Ovarian Vein Embolization

This is a nonsurgical day surgery procedure done under light intravenous sedation. It involves inserting a small 2 mm tube called catheter from the groin and advancing into pelvic veins selectively under guidance. The procedure takes about one hour. There is no pain post-procedure with some patients describing mild discomfort for a day or two. Most patients are back to full activity within a couple of days.