|
Pelvic Venous Congestion Syndrome (Chronic Pelvic Pain)Many women suffer from chronic pelvic pain, a sometimes debilitating condition that can be caused by varicose veins in the pelvis (Pelvic Venous Congestion Syndrome). Symptoms may include pelvic pain that worsens towards the end of the day or after long periods of standing, pain during or after intercourse, or varicose (swollen) veins of the vulva. The condition is difficult to diagnose, and historically has been treated with medication, psychological counseling and – as a last resort – hysterectomy.
Pelvic venous congestion syndrome is similar to the condition of varicose veins in the legs. In both cases, the valves in the veins that help blood flow toward the heart do not work properly. As a result, blood pools in the veins, and the veins in the affected body part stretch and bulge. In pelvic venous congestion syndrome, the enlarged veins cause pain in the area around the uterus, ovaries, and vulva. Historically, pelvic venous congestion syndrome has been hard to recognize and difficult to diagnose, sometimes leading to misdiagnosis and under-treatment. Interventional Radiologists now have a better understanding of Pelvic Venous Congestion Syndrome as well as how to diagnose the condition. Facts:About 15 percent of women, generally between the ages of 20 and 50, have some degree of pelvic varicose veins. Not all women with congested pelvic veins experience symptoms, but the pain can be debilitating in the more serious cases. The symptoms often occur during and after everyday activities, to the point where a woman's personal and professional relationships – and her sense of well being – can be affected. The exact cause of pelvic venous congestion syndrome is unknown. Current theories include:
Women with pelvic venous congestion syndrome also have a higher incidence of ovarian cysts, an enlarged uterus and a thickened endometrium (lining of the uterus) - all of which may be hormonally induced. And since it’s been found that estrogen-inhibiting drugs relieve the symptoms of pelvic venous congestion syndrome, more researchers support the theory that pelvic venous congestion syndrome is at least in part caused by hormonal dysfunction. It may be possible that multiple factors, including those discussed above, are responsible for pelvic venous congestion syndrome. Risk Factors:Women with pelvic venous congestion syndrome typically are:
Symptoms:The pain is typically described as dull and aching pain that periodically gets worse at the following times:
Diagnosis:Sometimes chronic pelvic pain does not seem to have an obvious cause. After gynecological testing has ruled out endometriosis, fibroids and uterine prolapse (a weakening of the abdominal muscles allowing the uterus to settle lower), and there are no obvious signs of inflammation, your physician may conclude that pelvic venous congestion syndrome is the cause of your pain. A specific diagnosis is made by examining the veins serving the pelvic organs. Tools and procedures that may be used by RANK physicians in the process include: Venography is a type of X-ray (called angiography) in which a thin, flexible tube, or catheter, is threaded into the blood vessels. A local anesthetic is given to numb the skin where the catheter is inserted, and X-rays are used to guide the catheter. A contrast agent, or dye, is injected through the catheter to highlight the blood vessel and call attention to any abnormalities. This procedure is conducted on an outpatient basis and can be performed quickly and painlessly by an interventional radiologist – a specialist who diagnoses and treats many vascular diseases and other conditions without surgery. Ultrasound - Pelvic ultrasound measures the thickness of the endometrium and the volume of the ovaries. Women with Pelvic Venous Congestion Syndrome typically have a thickened endometrium and enlarged ovaries. Transvaginal ultrasound visualizes the flow of blood in the pelvic cavity. Computed Tomography (CT) – sometimes called CAT scan – uses special x-ray equipment to obtain image data from different angles around the body, then uses computer processing of the information to show a cross-section of body tissues and organs. Magnetic Resonance Imaging (MRI) is a painless diagnostic test that can give accurate and clear information on the presence of tumors. MRI lets your doctor see detailed pictures of the inside of your body. MRI does not use X-Rays. Instead, strong magnets and radio waves work together to form a sharp image. There is no X-Ray radiation and the magnets and radio waves are harmless. Treatment Options:
VIA Interventional Radiologists can treat Pelvic Venous Congestion Syndrome with a relatively new interventional radiology treatment called Ovarian Vein Embolization.
|
