Chronic pelvic pain has a variety of reasons, but it is frequently linked to the development of ovarian and pelvic varicose veins. Varicose veins in the legs are similar to pelvic congestion syndrome or PCS. The valves in the veins that help return blood to the heart against gravity weaken and fail to shut correctly in both situations. This permits blood to flow backward and pool in the pelvic veins, generating pressure and bulging varicose veins in the pelvis and labial region. These veins can cause discomfort in the pelvis and impact the uterus, ovaries, and vulva.
Varicose veins in the pelvis affect up to 15% of women between the ages of 20 and 50; however, not everyone experiences symptoms. Because women lie down for a pelvic exam, the ovarian veins are relieved of pressure and do not bulge with blood as they do when they are upright; the diagnosis is usually ignored. To find out more, one can read about PAD symptoms and treatment.
Diagnosis and evaluation
Although varicose veins in the pelvis can cause discomfort and are a feature of pelvic congestion syndrome (PCS), many healthy women, especially those who have had children, will have enlarged pelvic veins found on an ultrasound, CT, or MRI scan. Fortunately, not everyone experiences symptoms, and PCS is only diagnosed in women who are in pain. Pelvic congestion syndrome can be diagnosed using a variety of minimally invasive procedures when other abnormalities or inflammation have been ruled out by a thorough pelvic exam:
- Pelvic venography: A venogram is conducted by injecting X-ray dye into the pelvis veins to make them detectable during an X-ray, which is thought to be the most accurate diagnostic technique.
- MRI: The best non-invasive technique to diagnose pelvic congestion syndrome is using an MRI. The exam must be performed in a specially designed manner to examine the pelvic blood vessels. The anomaly may not be seen on a routine MRI.
- Pelvic ultrasound: Unless done in a very precise way with the patient standing while the study is being done, pelvic ultrasound is usually not very helpful in detecting pelvic congestion syndrome. Ultrasound can be performed to rule out other potential causes of pelvic discomfort.
- Transvaginal ultrasonography: It is a method that allows doctors to view the pelvic cavity more clearly. It’s not as excellent as a pelvic ultrasound at visualizing the pelvic veins unless the lady is standing. It can, however, be used to rule out other issues.
Gynecologic pelvic examinations are frequently unremarkable. Other testing and surgical examinations, including laparoscopy and hysteroscopy, may not reveal any dilated or engorged veins. If you experience the characteristic pattern of pelvic discomfort associated with PCS, talk to your gynecologist about the potential of this diagnosis, and he or she may help you choose the right tests.
Treatment
The main objective of transvaginal mesh implant treatment is to alleviate your persistent pelvic discomfort while also improving your overall comfort. Depending on the severity of your symptoms, your doctor may try a variety of therapies to see what works best for you. Medication and embolization are two common therapeutic options.
- Medication: Your doctor may offer over-the-counter nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, if your pain is not severe and does not interfere with your daily activities. Pelvic congestion syndrome can also be treated with hormonal treatment.
- Embolization: Your doctor will use a chemical agent or a tiny metal coil to restrict blood flow through varicose veins during this treatment. Embolization is done at a hospital or a medical clinic using specialized equipment. You can either go home the same day or stay in the hospital overnight. Every stage of your pelvic congestion syndrome diagnosis and treatment may be trusted to be done by a certified and expert team of gynecologists.
Recovery
While the symptoms of pelvic congestion syndrome differ from woman to woman, it is usually treatable. Symptoms can be reduced or eliminated, allowing you to resume a better quality of life. Due to discomfort, you may have a loss of physical and sexual activity throughout therapy and recuperation. This can lead to depression, which is something to be concerned about. It’s critical to talk to your doctor about therapy if you’re having trouble managing the discomfort and inconvenience to your activities. Finally, unless you are in severe discomfort, you should be able to leave the hospital within 24 hours of having an embolization surgery. Pain is usually controlled with oral pain medication, and you should be able to resume your normal activities in about a week.