Pelvic pain relief is possible
FOR MANY WOMEN, pelvic pain is an uncomfortable, frustrating part of everyday life. This pain can be caused by pelvic venous congestion syndrome (PVCS), also known as pelvic venous disease.
In PVCS, women feel pain below the belly button, and it can worsen during menstrual cycles or after a long day of sitting or standing. PVCS is often overlooked or can be difficult to diagnose because there are many other causes of pelvic pain.
The syndrome occurs mostly in women who have been pregnant or who have vein compression syndromes. In the pelvis, veins have one-way valves that help keep blood flowing toward the heart. During pregnancy, ovarian and pelvic veins widen to accommodate increased blood flow from the uterus. If the valves are weak or damaged, and the veins fail to return to normal size after pregnancy, the blood backs up and the veins become congested, which can be painful. Other symptoms include pain on one or both sides of the pelvis, a feeling of fullness in the legs or incontinence due to the enlarged veins pressing the bladder or rectum.
Doctors can perform tests to determine if the pain is caused by venous congestion. These can include pelvic or transvaginal ultrasound, an MRI or a CT scan. A doctor might also perform a pelvic venogram, a test in which a special dye is injected into the veins so they will show up on an X-ray.
Treatment for PCVS is determined by the severity of the congestion. Hormonal medications prescribed by a gynecologist can reduce the pelvic congestion. If this is ineffective, then PVCS can be treated with a minimally invasive procedure called ovarian vein embolization. Using interventional radiology, a catheter is inserted through a small incision and seals off the vein, relieving the painful pressure. Intravenous medications are provided for comfort and relaxation, and patients go home the same day. Typically, they can return to work the next day, and resume normal activities in a week.
If you are experiencing pelvic pain, know that relief is possible. Talk to your gynecologist about your symptoms and treatment options.
DR. MERVE OZEN is an assistant professor of radiology and surgery in the Uterine Fibroid Program at UK HealthCare.
