Pelvic congestion syndrome – Diagnosis and treatment

Pelvic Congestion Syndrome is a cause of chronic pelvic pain in 30-40% of young women. This is a complex problem due to ovarian vein reflux and may be associated with reflux in the internal iliac vein tributaries causing pudendal varicosities. Effective treatment for this condition involves a multi disciplinary approach including gynaecologist, vascular surgeon and interventional radiologist supported by appropriate investigations. Investigations may include Ultrasound examination, Transvaginal Ultrasound, CT venogram, MRI venogram and Pelvic Venography. Successful treatment of this condition may involve embolisation of ovarian veins, internal iliac vein tributaries, foam sclerotherapy, and relief of mechanical obstruction to the iliac vein, retroaortic renal vein and nutcracker syndrome. Majority of women (85%) find improvement in their symptoms within 2 weeks of the treatment procedure.