Health Watch: Pelvic Congestion Syndrome

Dr. Colleen Harker with Mountain Medical gives us a look into this condition.

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Approximately one-third of all women will experience chronic pelvic pain during their lifetime. Chronic pelvic pain is a complex medical problem, with multiple different causes. Women may spend many years of their life trying to find a cause of their chronic pelvic pain, and the reality of living with chronic pelvic pain not only negatively affects the woman, but also her interactions with family and friends, and the general outlook on her life. However, up to 30% of patients with chronic pelvic pain have pelvic congestion syndrome, which is a treatable condition, often using minimally invasive procedures.

What is Pelvic Congestion Syndrome?

Pelvic Congestion Syndrome consists of “Varicose veins” of the ovaries and pelvis. The pathology is similar to varicose veins in the legs, caused by malfunctioning valves within the veins and allowing blood to pool backwards.

What are the symptoms of Pelvic Congestion Syndrome?

Most common symptom is pelvic pain that is related to gravity – little to no pain while lying flat and in the morning hours, with the pain worsening throughout the day with standing and sitting.

Other symptoms include increased pelvic pain during pregnancy, associated with menstrual periods and following intercourse. There also may be association with varicose veins of upper thigh, buttock &/or vulvar regions.

Risk Factors:

• Usually affects women in their child-bearing years

• Previous Pregnancies (especially, two or more)

• Varicose veins of legs

• Hormonal dysfunction

How is pelvic congestion syndrome diagnosed?

A combination of physical examination and clinical history should be strongly considered when other pelvic diseases are ruled out, and especially in combination with “gravity-related” pelvic pain, with or without leg and vulvar varicose veins.

Patients can also confirm the diagnosis with imaging techniques.

Ultrasound or CT scan – enlarged veins may be seen surrounding the ovaries and pelvis.

MRI Venogram – when pelvic congestion syndrome is strongly suspected, this can help to confirm the diagnosis.

Pelvic Venogram – considered the “gold standard”. Placing dye within the ovarian and pelvic veins, and allows treatment (embolization of abnormal veins) at the time of venogram.

How can pelvic congestion syndrome be treated?

Mild symptoms may be managed with analgesics, possibly hormones.
Moderate to severe symptoms need definitive treatment-


Surgery: includes removal of uterus and possibly ovaries, surgically tying off of ovarian veins

Pelvic venogram with embolization of abnormal veins: minimally invasive, outpatient technique. Access the veins usually through a vein in the lower neck (jugular vein), place tiny tube (catheter) into the different veins which are suspected to be abnormal and nonfunctioning, inject small amount of dye and take x-ray pictures. If veins are abnormal, place coils, and sometimes liquid, to close the veins.


Technical success: 95-100%

Clinical success: 85-95% patients have significant or complete improvement in symptoms

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For more information, call (801) 713-0616.

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