Chronic Pelvic Pain in Women

Chronic Pelvic Pain Treatment

Chronic pelvic pain in women is a significant health problem. There are many causes including:

  • Endometriosis
  • Colitis
  • Chronic cystitis
  • Pelvic infection (PID)
  • Past history of sexual abuse

Pelvic congestion syndrome (PCS) is a pelvic pain syndrome due to internal, usually invisible, varicose veins in the pelvis. They are fed abnormally high pressure by abnormal, enlarged ovarian veins.

(Left) A CT scan shows a tangle of dilated veins in the pelvis (Right) An ovarian venogram shows the veins crossing through the pelvis around the uterus.

The veins have been blocked with platinum coils and scleroscants, non-surgically. Patients may have chronic aching or burning pain, sometimes worse with menses, worse when active, better after sleep. They usually have a negative work up for other causes of pelvic pain. The syndrome is more common after having had multiple pregnancies. Patients are sometimes classified as being “nuts.”

These veins often are missed by laproscopy and ultrasound. We can sometimes see them on MRI and CT scan.

They can reliably be seen on a simple outpatient test called an ovarian venogram. A small catheter is slipped into a vein after numbing the skin and steered into the abnormal veins. This is not painful. Dye is injected to map them, then they are blocked (embolized) with platinum coils and sclerosing agents. This outpatient procedure may relieve the pain immediately.

We have performed this procedure for over 10 years. PCS is poorly understood by much of the medical community, and certainly is under-diagnosed. For more information contact us or call (630) 856-7460.