Chronic pelvic pain is defined as pain in the lower abdomen/pelvis lasting longer than 6 months and effects approximately 15-40% of women aged 20-50yo. 60% of women who suffer from pelvic pain never get a proper diagnosis. Many of these women undergo extensive workups for numerous gynecologic or musculoskeletal sources of the pain but are eventually told there is nothing wrong with them. Are these women crazy? Or is there something else going on that we as Physicians are failing to evaluate?
What about Pelvic Congestion Syndrome? The problem is caused by a condition know as pelvic venous insufficiency or varicose veins within the pelvis. This causes blood to pool within the bulging veins of the pelvis, subsequently causing pain. These abnormal veins can be secondary to abnormalities of the gonadal veins or a compression of a vein in the pelvis called, May-Thurner. There is a broad range of symptoms for PCS and pelvic pain including: pelvic pain, low back pain, hip pain, abnormal discharge, POTS, fatigue, interstitial cystitis, and fibromyalgia to name a few.
So why has no one told you about this until now? PCS is not widely known of or thought of by most primary care physicians or gynecologist. PCS is typically evaluated and treated by Vascular & Interventional Radiologists. Initial evaluation involves clinic visit/consultation followed by imaging evaluation of the abdomen and pelvis, typically called a CT venogram. The imaging allows the Physician to look for dilated pelvic veins as well as potential compression of the left iliac vein, aka May-Thurner. If the imaging, along with clinical history, point to PCS, treatment involves performing a pelvic venogram or dye study under live X-ray. If May-Thurner is demonstrated, a stent is typically placed to restore normal blood flow and decrease pressure within the veins of the pelvis. If persistent leaky, abnormal veins are demonstrated within the pelvis after stent placement, typically a medication is administered within the veins to shrink them and relieve symptoms. We have found most patients receive 80-100% improvement of their symptoms following treatment.
If PCS sounds like a condition you may have please check out www.veinsolutionsokc.com for more information.