When is pelvic congestion syndrome suspected?Pelvic congestion syndrome is suspected when a patient’s chronic pelvic pain cannot be explained by other causes. Meaning, PCS is often a diagnosis of exclusion. The pelvis contains various organs such as the urinary bladder, uterus, cervix, vagina, bowel, and rectum. Pathology in any of these organs can cause pelvic pain. As a result, the list of potential causes of chronic pelvic pain is long and varied, including fibroids, pelvic inflammatory disease, ovarian cysts, bowel diseases, and bladder pathology. An OB/GYN typically begins evaluation for chronic pelvic pain with a pelvic examination, Pap smear, routine laboratory tests, and imaging.2 Once other pelvic causes of pain have been ruled out, an interventional radiology consultation may be recommended for additional assessment and treatment of pelvic congestion syndrome.
How is pelvic congestion syndrome diagnosed?Some of the imaging tests that can help diagnose pelvic congestion syndrome include:2 Pelvic ultrasound: This is generally the first imaging study performed in patients who have chronic pelvic pain. It is a non-invasive, non-radiating imaging test that takes about 30 minutes to complete. Visualization of enlarged, twisted pelvic veins and slow and retrograde (reversed) blood flow in the veins are indicative of pelvic congestion syndrome. Pelvic CT scan: A CT scan of the pelvis can demonstrate varicose veins in the pelvis in greater detail than an ultrasound. However, a CT scan is associated with radiation exposure. MR venogram: A magnetic resonance venogram is the gold standard in the diagnosis of pelvic congestion syndrome. It is an outpatient, non-invasive, non-radiating imaging study that can demonstrate varicose veins near the uterus, ovaries, and pelvic wall, thus confirming the diagnosis of pelvic congestion syndrome. Laparoscopy: This is a surgical diagnostic procedure that allows doctors to look directly at organs in the abdomen and pelvis with the help of a camera that is inserted through small incisions. It is a minimally-invasive procedure that may be advised to rule out other causes of chronic pelvic pain and arrive at a diagnosis of PCS by exclusion. In the United States, 15 out of every 100 women in the 18-50 years age group have chronic pelvic pain.3 The good news is that effective treatments are available for many of the conditions that cause long-standing pain in the pelvis, including pelvic congestion syndrome.
Why California Vascular & Interventional?At CVI, we provide devoted and specialized care for embolization. All clinical decisions are centered on the patient because CVI is owned and controlled by our physician, who is an embolization expert. The doctor has the freedom to spend as much time as needed for patient consultations and medical procedures. Clinical decisions are made based on what is best for you and your treatment, and not influenced by the interests of a profit-driven hedge fund company. The staff are highly trained and dedicated to the patient experience. This allows us to provide the best care and experience for our patients. Women continue to be thrilled with the totality of their care experience facilitated by our patient-centered approach. Read more about our practice here.
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Contact us today to find out if you are candidate for embolization. You can obtain a consultation virtually via a video telehealth platform or meet our doctor in person at one of our office locations in Los Angeles or Southern California.
- Kuligowska E, Deeds L 3rd, Lu K 3rd. Pelvic pain: overlooked and underdiagnosed gynecologic conditions. Radiographics. 2005 Jan-Feb;25(1):3-20. doi: 10.1148/rg.251045511. PMID: 15653583. Available online. Accessed on October 11, 2020. https://pubmed.ncbi.nlm.nih.gov/15653583/
- Ignacio EA, Dua R, Sarin S, et al. Pelvic congestion syndrome: diagnosis and treatment. Semin Intervent Radiol. 2008;25(4):361-368. doi:10.1055/s-0028-1102998. Available online. Accessed on October 11, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036528/
- Durham JD, Machan L. Pelvic congestion syndrome. Semin Intervent Radiol. 2013;30(4):372-380. doi:10.1055/s-0033-1359731. Available online. Accessed on October 11, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835435