
Pelvic congestion syndrome occurs mainly in young women. It is the result of insufficiency of the veins located in the pelvis. In particular, the ovarian vein (gonadal vein) malfunctions, causing blood to pool in the pelvic veins around the ovaries and uterus leading to congestion and distension of the veins causing symptoms.
Symptoms:
- Chronic pelvic pain
- Pain during intercourse (dyspareunia)
- Presence of vulvar varicose veins
- Presence of lower extremity varicose veins
The diagnosis of the syndrome can be made by ultrasound, CT or Magnetic venography. Traditional venography is mainly combined with therapeutic methods at the same time.
For the final diagnosis, a thorough gynecological examination is also required to rule out other possible causes such as endometriosis. Other syndromes such as May-Thurner syndrome (compression of the left iliac vein) or nutcracker syndrome (compression of the left renal vein) must also be excluded.
Drug treatments may improve symptoms, but symptoms usually reappears after the treatment is stopped.
The most effective treatment is the minimally invasive embolization of the left ovarian vein.
Under local anesthesia, the femoral vein in the groin is located with ultrasound and a puncture is performed. The left renal vein and then the left ovarian vein are catheterized. After confirmation of the findings of the insufficiency, the veins are embolized with coils and sclerosing agent. The patient is discharged home the same day.
