“Pelvic Congestion Syndrome Explained”

“Pelvic Congestion Syndrome Explained”

As a vascular consultant , we see many patient with varicoseveins and pelvic congestion syndrome so Let’s unpack pelvic congestionsyndrome—what happens is that the ovarian vein starts to dilate, kind of like aballoon under pressure, and that’s when the pelvic veins begin to congest. It’sthe same principle behind the varicose veins we often see—only this time, theissue is deeper, and the impact is on pelvic circulation.”

Chronic pelvic pain: A dull, achy, or heavysensation that may also be sharp or throbbing. Typically worsens with prolongedstanding or sitting and tends to improve when lying down.

Pain during or after intercourse (dyspareunia):Often described as significant and uncomfortable.

Menstrual-related pain (dysmenorrhea): Pain mayintensify just before or during the menstrual cycle.

Lower back and leg discomfort: Aching or burningsensations often radiate from the pelvic region.

Visible varicose veins: Can appear around thevulva, thighs, buttocks, or vaginal area.

A patient with pelvic congestionsyndrome

BlendedSymptoms, Dual Diagnosis: When PCS Meets Varicose Veins

In our vascular clinic, somepatients present with symptoms that’ve clearly crossed over—mixing thehallmarks of both pelvic congestion syndrome and varicose veins. When thishappens, it’s essential to evaluate every symptom carefully and sort them intotwo clear categories. Here’s how you can approach it.

1. Pelvic Congestion Syndrome (PCS) Cluster

Symptoms here tend to revolve around deep pelvic venous congestion,including:

·        Persistent dull, aching, or draggingpelvic pain—often worsening by day’s end, especially with prolongedstanding or during/after sex or menses

·        Low back pain, legdiscomfort, and sensations of pelvic fullness or heaviness.

·        Pelvic and vulvar varicosities—veinsvisible around the vulva, buttocks, or inner thighs.

·        Urinary (e.g., urgency,pain) and bowel symptoms, including irritable bladder or bowelpatterns

2. Lower-Extremity Varicose Vein Symptoms

These typically mirror traditional venous insufficiency signs:

·        Aching, heavy legs,often with visible spider veins or bulging veins on the legs

·        Swelling, itching, skindiscoloration, cramps, or stasis dermatitis near ankles

·        Improvement with leg elevation and response tocompression therapy

Why This Dual-Track Clarity Matters

·        Accurate Diagnosis:Each set of symptoms may stem from different venous sources. Lower limbsymptoms may mask underlying pelvic venous insufficiency—and vice versa

·        Targeted Work-up:If leg symptoms persist after treating varicose veins, consider imaging (e.g.,duplex ultrasound including pelvic evaluation) to check for pelvic reflux orovarian vein involvement

·        Personalized Treatment:While compression and sclerotherapy might help leg symptoms, addressing PCS maycall for pelvic-focused imaging and possible embolization

By structuring your clinical narrative andevaluation along these two clear lines, you ensure patients receive precisediagnostics and appropriately targeted therapies—whether pelvic, peripheral, orboth.

HERE AT BANKERS VASCULAR HOSPITAL, WE ENSUREOUR PATIENTS RECEIVE THE BEST NON‑SURGICAL TREATMENT OPTIONS AVAILABLE.

At Bankers Vascular Hospital, our interventional radiology team specializesin delivering highly effective, minimally invasive care—using precise needlepunctures rather than traditional surgeries, cuts, or sutures—across conditionslike varicose veins, knee pain (e.g., GAE), uterine fibroids, and more.

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