Pelvic congestion syndrome (PCS) or “pelvic varicose veins” is a poorly understood and often overlooked cause of chronic pelvic pain.
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Millions of women worldwide develop chronic pelvic pain at some time in their life and pelvic congestion is present in at least 30 per cent of them but unfortunately not many doctors will look for it.
Chronic pelvic pain can be very debilitating and often patients undergo lots of investigations with no answers and eventually many of them are told that there is nothing wrong, and that it is “all in their head”.
Associate Professor Laurencia Villalba from the Vascular Care Centre said, “Managing this complex condition can be a challenge for the primary-care provider. When most examinations are normal, a referral to a vascular specialist can be helpful to obtain the diagnosis. Once identified, PCS can be treated successfully with minimally invasive techniques.”
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The diagnosis for PCS is challenging since there might be multiple factors involved. Women typically complain of a dull, throbbing and achy pain in the pelvis and /or vulva region. The pain can radiate to the legs.
It often worsens as the day goes by, during or after intercourse or just before the onset of menses and is relieved by lying flat. Typically, women with PCS will not be symptomatic in the morning but will become so with prolonged standing or sitting and after exercise.
Some patients may or may not also have vulva varicosities or varicosities along the lateral thighs or buttocks.
They can also complain about bladder irritability, bowel symptoms or lower back pain.
“At the Vascular Care Centre we have developed a new ultrasound criteria (recently published in a peer reviewed medical journal) to help us diagnose patients with pelvic congestion syndrome; this complemented with a comprehensive approach is helping us identify patients that could benefit from intervention,” A/Prof Villalba said.
“The treatment plan is tailored to each individual patient. It is day surgery under local anaesthetic with quick return to normal activities.
“The success rate in well selected patients is high with more than 80 per cent enjoying a return to a life without pain after many years of searching.”
The Vascular Care Centre is located in Crown Street, Wollongong and Junction Street, Nowra. For information phone 4211 0400 or go to vascularcarecentre.com
