Pelvic Congestion Syndrome
Pelvic Congestion Syndrome
By Eric Daiter MD
Pelvic congestion refers to a malfunction in the veins of the pelvic area. Blood should normally flow from the pelvic area to the heart. There are valves in these veins that keep the blood from retreating back. If the valves malfunction, then blood can flow backward and settle down in the pelvic area. This can cause many different symptoms and ultimately pelvic congestion syndrome.
Pelvic congestion syndrome has many symptoms. They include painful periods, vaginal discharge, back pain, pain during and long after intercourse, ovary tenderness and pain, and can even affect the bladder. Because these symptoms closely resemble other disorders, pelvic congestion syndrome can be misdiagnosed or overlooked. Uterine fibroids, endometriosis and other disorders have many of the same symptoms. In pelvic congestion syndrome, the affected veins bulge and stretch causing a lot of pain. Specific tests are needed to get an accurate diagnosis of pelvic congestion syndrome and it is not usually discovered until the patient seeks treatment for infertility.
Diagnostic laparoscopic surgery is commonly used to diagnose endometriosis and pelvic congestion syndrome. With laparoscopy, the doctor can visually inspect the outside of the uterus, ovaries and other pelvic features that may be affected. An MRI may also be used to aid in the diagnosis of pelvic congestion syndrome. The veins affected by pelvic congestion syndrome look like varicose veins. They are essentially the same thing, bulging stretching veins whose valves are not working right.
Occasionally, women will have varicose vein treatment in their legs and experience no relief of symptoms. Sometimes this is because the problem is stemming from pelvic congestion disorder. A tipped or prolapsed uterus can put you at a higher risk for this disorder. Multiple pregnancies may also put you at a higher risk due to the strain that it has on your uterus and surrounding organs.
Hormonal therapy and other drugs can be used to constrict the veins that are affected. Sometimes the veins will actually need to be blocked to help. This can be done surgically or by injection of an embolic agent. Your treatment will depend on the severity of your actual condition. If your uterus is folded or tipped, your doctor might recommend an internal sling which suspends the uterus in the right position. This can help relieve symptoms and get the blood flowing in the right direction and minimize pooling and stretching.
If all else fails then you may need a hysterectomy. This should really be the last thing that you try, as it is a much more invasive surgery and can take a long time to recover from. If infertility treatment is needed, you should seek the help of an experienced and skilled infertility specialist.
Dr. Eric Daiter MD is the medical director of The NJ Center for Fertility and Reproductive Medicine, LLC.