Vascular
Pelvic Congestion Syndrome
A chronic condition in women caused by varicose veins in the lower abdomen and pelvis, leading to persistent pelvic pain.
Pelvic congestion syndrome is a vascular cause of chronic pelvic pain in women, resulting from dilated and incompetent pelvic veins. It is often misdiagnosed but highly treatable through minimally invasive intervention.
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Pelvic congestion syndrome involves varicose veins in the pelvis, which can cause chronic, heavy pelvic pain that worsens throughout the day.
Symptoms
- Dull, aching pelvic pain lasting over six months
- Worsens with prolonged standing or sitting and toward the end of the day
- Improves when lying down
- Pain intensifies during and after intercourse and menstruation
- Pelvic heaviness and visible vulvar or thigh varicose veins
- Possible bladder urgency or bowel symptoms
Causes & Risk Factors
- Weakened or failed vein valves
- Multiple pregnancies (primary risk factor)
- Oestrogen effects on vein wall laxity
- Family history of varicose veins
- Nutcracker syndrome (left renal vein compression)
Diagnosis
- Pelvic duplex ultrasound (first-line)
- CT or MR venography
- Catheter-based venography (definitive)
Treatment Options
- Pelvic vein embolisation — catheter-based procedure under local anaesthesia; highly effective
- Supplementary sclerotherapy for associated varicosities
- Conservative: compression garments, postural adjustments, hormonal therapy
Concerned About Pelvic Congestion Syndrome?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.