Pelvic Congestion Syndrome

Chronic pelvic painPCS anatomical graphic

Causes of chronic pelvic pain are varied, but are often associated with pelvic varicose veins also known as pelvic congestion syndrome (PCS) when other etiologies are not found such as uterine/ovarian abnormalities. PCS is similar to varicose veins in the legs. Both result when the valves in the vein become weakened and do not close properly allowing blood to flow backwards and pool in the vein causing pressure and bulging veins. Since this worsens with sitting/standing (due to backup from gravity), symptoms often worsen throughout the day.

Common signs:

  • Leg/pelvic/buttock pain, aching or cramping
  • Pelvic discomfort and fullness throughout the month
  • Pelvic bloating
  • Pain/aching with and/or after intercourse
  • Pelvic/abdominal tenderness

Symptoms may be worse:

  • After standing for long periods of time
  • Following intercourse
  • During menstrual periods
  • During/following pregnancy

Signs of PCS may include:

  • Irritable bladder
  • Varicose veins on vulva, buttocks or thigh
  • Leg swelling/ Varicose Veins

PCS can affect anyone, but is most common between the ages of 30-50 years old. Other factors that may increase your risk, include:

  • History of varicose veins
  • Two or more pregnancies
  • Polycystic ovaries
  • Hormonal dysfunction

Evaluation of PCS:

  • A specialized ultrasound is performed to evaluate pelvic veins. The Interventional Radiologist providers will then go over the findings and treatment options.

PCS Treatment

The treatment is an outpatient minimally invasive procedure performed by an interventional radiologists using image guidance. This procedure is carried out under local anesthesia with intravenous sedation, to assure patient comfort. A small catheter is placed into the vein to perform a diagnostic venogram. Blood supply to the pelvic varices is then blocked by the use of surgical plugs and/or embolic agents. The blood is then rerouted from the damaged veins, into healthy veins. After the procedure, patients can return home or to work immediately. The patient may experience some pelvic discomfort within the first 72 hours, which will be medically managed.

Benefits of Embolization

  • Resume normal activities the same day
  • Relief of throbbing pelvis
  • Relief of pelvic & leg heaviness
  • No inpatient hospitalization or bed rest
  • Short in office procedure
  • Improved outcome of varicose vein treatment in legs

Treatment outcomes

  • 85-95% success rate in pain reduction following the procedure

You or your physician can schedule an office consultation with Dr. Dunleavy & the IR Team. Once referred, the IR team will conduct an initial consult that includes your medical history, a physical exam and an evaluation your pelvis and legs prior to any treatment. The Interventional and Vascular Radiology clinic works collaboratively with your Gynecologist, Primary Care Physician and other physicians. Dr. Dana Dunleavy leads the Interventional and Vascular Radiology team as a fellowship trained Interventional Radiologist from Johns Hopkins. In addition, he has achieved a certificate of added qualifications (CAQ) in Interventional and Vascular Radiology. Windsong Radiology Group maintains accreditation with the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) to provide patients minimally invasive procedures in an outpatient setting.

Call for an appointment on our direct line at (716) 929-9484

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