Many women suffer through chronic pelvic pain (CPP). In the U.S. it’s estimated that over 9 million women suffer from CPP. Many of those women have CPP specifically due to bulging ovarian and pelvic veins in a condition known as pelvic congestion syndrome (PCS).
This is an often under-diagnosed in many women by other clinicians. But Dr. Rami has extensive experience diagnosing and treating PCS and CPP. Here’s more about this condition and its treatment.
What is pelvic congestion syndrome?
When a woman’s pelvic pain is defined as “non-cyclic,” lasting greater than six months, it becomes CPP and PCS is often the cause. The pain is usually characterized by a dull ache deep in the pelvis. It is usually the most painful when the woman is in an upright position, be it standing, sitting, walking, or running. The pain may radiate into the lower back and down the thighs; it may be worse leading into menstruation. Periods can be heavy and of a longer duration. Sexual intercourse can also involve pain, either during or afterwards.
What causes PCS?
While not called varicose veins because they aren’t near the surface of the legs, the cause of PCS is basically the same. Healthy veins have valves that prevent backflow, ensuring the blood flows back to the heart in only one direction. But when the valves weaken, they allow the blood to flow backwards and pool in certain spots. On the legs, these are varicose veins. In the pelvis, it causes congestion and raises venous pressure. This leads to pooling of stagnant blood resulting in engorged, dilated, and stretched pelvic veins. This causes chronic pelvic pain.
Most clinicians can miss the diagnosis of PCS. This is because PAP smears, gynecological or rectal exams, pelvic ultrasound, and CT scans usually show “normal” results, unless the doctor is looking for PCS.
Dr. Rami uses a venogram, a minimally invasive test that definitely shows the problems with the pelvic veins.
Ovarian vein embolization (OVE) is the most effective treatment for PCS. It involves blocking one or both refluxing ovarian veins internally. Dr. Rami has performed several hundred embolization procedures and it is very successful.
Dr. Rami inserts a catheter into the jugular or femoral artery, guiding it with x-rays. The venogram is performed using contrast x-ray dye to identify the veins and the direction of the blood flow. Once the backflow is confirmed, the vessel is permanently blocked with stainless steel or platinum coils fed through the catheter. This often is accompanied by a sclerosing agent that causes the vein walls to collapse, further ensuring that the vein closes off. No incisions or stitches are required and the patient feels nothing while this is happening.
Do you have ongoing pelvic pain? You could be suffering from pelvic congestion syndrome. Call Dr. Rami at (623) 847-3884 to schedule an appointment so we can get rid of the pain.