Pelvic Congestion Syndrome: Diagnostic Challenge and Endovascular Treatment

Marc Salomon, Jessica Goldman and Sohail Contractor

Department of Radiology, Rutgers New Jersey Medical School, Newark, USA

^*Correspondance to: Marc Salomon 

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Abstract:

Pelvic congestion syndrome (PCS) is comprised of a constellation of symptoms including noncyclical pelvic pain, pelvic varicosities, dysmenorrhea, and dyspareunia. There is a higher incidence of PCS in young, multiparous, pre-menopausal women in the age range of 20-40 years. Symptoms worsen through the day and are exacerbated by standing and increased physical activity. Patients often experience relief in supine position. The diagnosis of PCS should be considered when a premenopausal multiparous woman presents with pelvic pain of greater than 6 months’ duration and is found to have pelvic varices on non-invasive imaging (MRV, transvaginal ultrasound). The diagnosis is typically confirmed by venography demonstrating dilatation of and reflux within the ovarian vein, which occurs more commonly on the left side due to its drainage into the left renal vein (often considered the female equivalent of scrotal varicoceles). Ovarian vein venography and embolization to prevent further reflux is the first-line treatment with resolution of symptoms seen in 70-90% of patients. Here, we report the case of a patient who presented with the classic signs of PCS and underwent ovarian vein embolization therapy.

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Cite the Article:

Salomon M, Goldman J, Contractor S. Pelvic Congestion Syndrome: Diagnostic Challenge and Endovascular Treatment. Ann Clin Case Rep. 2017; 2: 1344.