Pelvic congestion syndrome

Diagnosis of pelvic congestion syndrome

It is not easy to diagnose pelvic congestion syndrome because the symptoms are similar to symptoms of other conditions, and there is no single test that can definitively identify it. For this reason, in addition to discussing your symptoms and your medical and family histories, your doctor will run a number of tests to rule out other causes.

Imaging tests may be the most valuable for diagnosing pelvic congestion syndrome because they can provide a view of the soft tissue and often can detect the presence of enlarged blood vessels. Ultrasound is the starting point for getting an image of the pelvic region.

When a more detailed image is needed, your doctor may order a CT scan or an MRI scan. The CT scan is a special type of x-ray that takes cross-sectional images of the body. An MRI is a scan that uses radio waves and magnets to create an image of inside the body.

Another imaging test that may be used is called a venogram. This test requires the injection of a contrast dye into your veins so they will show up on an x-ray. This will allow your doctor to see the size and shape of the veins and detect any abnormalities.

Finally, your doctor may perform a laparoscopy, particularly if the other imaging tests did not reveal the cause of the pelvic pain. Laparoscopy is a procedure in which a lighted camera is inserted through a tiny abdominal incision. This allows your doctor to get a good view of the pelvic organs and look for any abnormalities.

Treatment

The main goal of treatment is to reduce your chronic pelvic pain and increase your overall comfort level. Your doctor may experiment with different treatments to determine what works best for you, depending on the severity of your symptoms. Common treatment methods include medication and embolization.

Medication

If your pain is not severe and does not limit your life, your doctor may recommend over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Hormonal medication may also be used to treat pelvic congestion syndrome.

Embolization

During this procedure, your doctor blocks blood flow through varicose veins by using a chemical agent or small metal coil. Embolization is performed in a hospital or specially equipped medical clinic. You may go home the same day or stay overnight at a hospital. You can trust Dignity Health’s experienced team of gynecologists with every step of your pelvic congestion syndrome diagnosis and treatment .

Preparation

The only preparation you need for your initial appointment is to be prepared to discuss your symptoms and medical history. You may also have an initial pelvic exam, so scheduling your appointment at a time when you aren’t menstruating is recommended. There is no preparation required for imaging tests.

If your doctor chooses to perform laparoscopy, there are some things you need to do prior to the procedure, including:

  • Not eating, drinking, or smoking after midnight the night before the procedure
  • Wearing flat or low-heeled shoes to the procedure
  • Removing all nail polish
  • Wearing loose-fitting clothes
  • Removing all jewelry
  • Ensuring you have someone to take you home after the procedure

If you require embolization, you will do the same preparations as listed above. In addition, you will need to stop taking blood thinners and vitamin E a minimum of five days before the procedure. You will be able to speak with your doctor and healthcare team ahead of time to ask any questions and learn everything you need to know about the procedure.

Recovery

While the effects of pelvic congestion syndrome vary among women, in most cases, it can be managed. Symptoms can be eliminated or improved, allowing you to get back to a higher quality of life.

During treatment and recovery, you may experience a loss of physical and sexual activity due to pain. This can lead to depression, which should be taken seriously. If you need help coping with the pain and disruption to your activities, it is essential to speak to your doctor about counseling.

Finally, if you have an embolization procedure done, you can expect to leave the hospital within 24 hours, unless you are experiencing significant pain. Pain is typically managed using oral pain medication, and you will be able to return to your normal activities within a week.

The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.