Pelvic Congestion Syndrome

The chronic pain that is associated with this disease is usually dull and aching. The pain is usually felt in the lower abdomen and lower back. The pain often increases during the following times:

• Following intercourse
• Menstrual periods
• When tired or when standing (worse at end of the day)
• Pregnancy

Other symptoms include:

• Irritable bladder
• Abnormal menstrual bleeding
• Vaginal discharge
• Varicose veins on vulva, buttocks, or thigh

Risk factors include two or more pregnancies and hormonal increases, the fullness of leg vein, polycystic ovaries, or hormonal dysfunction.

Once other abnormalities or inflammation has been ruled out by a thorough pelvic exam, pelvic congestion syndrome can be diagnosed through several minimally invasive methods.

Pelvic Venography - Thought to be the most accurate method for diagnosis, a venogram is performed by injecting contrast dye in the veins of the pelvic organs to make them visible during an X-ray. To help the accuracy of diagnosis, interventional radiologists examine patients on an incline, because the veins decrease in size when lying flat.

MRI - One of the best non-invasive way of diagnosing pelvic congestion syndrome. The exam needs to be done in a way that is specifically adapted for looking at the pelvic blood vessels. A standard MRI may not show the abnormality.

Pelvic Ultrasound - Usually not very helpful in diagnosing pelvic congestion syndrome unless done in a very specific manner with the patient standing while the study is being done. Ultrasound may be used to exclude other problems that might be causing pelvic pain.

Transvaginal Ultrasound - This technique is used to see better inside the pelvic cavity. As with a pelvic ultrasound, it is not very good at visualizing the pelvic veins unless standing. However, it may be used to exclude other problems.