Pelvic Congestion Syndrome

Pelvic congestion syndrome (PCS) is a medical condition that causes chronic pain in the pelvis due to a buildup of blood in pelvic veins that are stretched and twisted, similar to varicose veins in the legs. Women who suffer from PCS experience severe, dull, aching pain lasting more than 6 months.

The University of Kansas Health System offers advanced, minimally invasive interventional radiology treatment for PCS. We work with every person to determine your individual needs for treatment options that can help reduce the symptoms of PCS and improve your overall quality of life.

Pelvic congestion syndrome is one of the leading causes of chronic pelvic pain, afflicting millions of women worldwide. The typical age of women diagnosed with PCS ranges from 20-45. Studies have shown that PCS accounts for 16-31% of chronic pelvic pain cases.

Although the painful symptoms of pelvic congestion syndrome are caused by blood building up in veins throughout the pelvic area, doctors aren’t sure quite what causes this to happen. Hormones may play a role, as could the number of pregnancies you’ve had.

The primary symptom associated with pelvic congestion syndrome is a dull ache but may also present as a sharp or throbbing sensation. PCS symptoms are made worse by long periods of sitting or standing, menstruation or sexual intercourse. The pain may diminish when lying down. PCS is often accompanied by:

• Abnormal vaginal bleeding
• Aches in the legs
• Lower back pain
• Vaginal discharge

Other pelvic congestion syndrome symptoms may include:

• Anxiety
• Depression
• Fatigue
• Urinary frequency

It is unclear whether there is a genetic or ethnic predisposition to PCS. The risk of developing PCS is higher among women who have had multiple pregnancies. The majority of women affected by pelvic congestion syndrome symptoms are premenopausal. Research indicates that PCS might be caused by naturally existing estrogen, which is known to weaken vein walls.

PCS is challenging to diagnose because the cause of chronic pelvic pain may not be apparent during a physical or gynecological exam. An interventional radiologist may be consulted for additional evaluation and treatment of PCS.

To rule out other pelvic venous conditions, imaging tests can be performed to make a specific diagnosis:

• A CT scan produces images of the pelvic varicose veins
• A pelvic ultrasound produces images of pelvic varicose veins and blood flow

For most outpatient visits, either a pelvic ultrasound or CT scan may only take 20-30 minutes to complete.

A venogram is the most accurate imaging technique to diagnose PCS because it shows real-time dynamic blood flow and a complete view of the pelvic venous anatomy.

Once a diagnosis has been confirmed, treatment options for pelvic congestion syndrome may be discussed with an interventional radiologist.