Pelvic Congestion Syndrome (PCS) Diagnosis and Treatment

Diagnosing pelvic congestion syndrome (PCS)

Although pelvic varicose veins can cause pain and are the hallmark of pelvic congestion syndrome (PCS), many normal women will have enlarged pelvic veins discovered on an ultrasound, CT, or MRI scan, especially if they have had children. Fortunately, not everyone gets symptoms and only those women who have pain are given the diagnosis of PCS.

Routine gynecologic pelvic exams are usually normal. Laparoscopy, hysteroscopy, and other tests and surgical investigations may also not show any dilated or engorged veins. If you have the typical pattern of pelvic pain of PCS, please discuss the possibility of this diagnosis with your gynecologist, who can then guide the choice of appropriate testing.

Treatment options for pelvic congestion syndrome (PCS)

There are several treatment options for pelvic congestion syndrome. Hormonal medications, prescribed by your gynecologist, can reduce blood flow and congestion of the varicose veins. If these are ineffective, then minimally invasive therapies may be considered such as nonsurgical embolization (intentional plugging) of the varicose veins. This is an outpatient procedure, in which an Interventional Radiologist inserts a small catheter (plastic tube) into a central vein in the upper arm, shoulder, or thigh and guides it to the problem area using X-ray guidance. No incisions or stitches are required and there is no sensation inside while this is happening. Intravenous medications are all that is required for comfort and relaxation.

The varicose veins are permanently sealed off from the inside. Patients typically return to work and light activities the following day, and to full activities in a week.

If you believe you have PCS and are interested in learning whether you are a candidate for embolization, visit the Internventional Radiology clinic for information about how to set up a consultation or referral.