Pelvic congestion syndrome (PCS): when chronic lower abdominal pain is not “normal”

Invisible pain in the pelvis – but not imaginary

Many women suffer from a dull, pressing pain in the lower abdomen – often independent of the menstrual cycle, chronic and aggravated by prolonged sitting or standing. But too rarely is a serious cause considered: pelvic congestion syndrome (PCS), also known as ovarian varicosis or pelvic vein congestion.

One in three women could be affected by this in the course of their lives – but hardly anyone is aware of the diagnosis. Today, there are modern, minimally invasive treatment methods such as endovascular coiling, which is offered at VenaZiel®.

What is Pelvic Congestion Syndrome (PCS)?

Pelvic congestion syndrome is a chronic venous disease. It is caused by varicose veins in the pelvic veins, particularly in the ovarian veins (ovarian veins) or internal pelvic veins. These dilated, overstretched veins lead to blood congestion, similar to varicose veins in the legs – only inside the body.

These pelvic varices exert pressure on surrounding organs, irritate nerves and lead to a number of unpleasant symptoms.

How common is PCS – and why is it so often overlooked?

It is estimated that one in three women of childbearing age is affected by pelvic varices – with or without symptoms. Despite this, PCS often goes unrecognized. Why?

• The symptoms are non-specific (e.g. abdominal pain, back pain).
• Many symptoms also occur with other illnesses (e.g. endometriosis, irritable bowel syndrome).
• Many doctors are not yet sufficiently aware of PCS.

PCS occurs particularly frequently with:

• Women between the ages of 20 and 50
• Women with multiple pregnancies
• Pre-existing family history (varicosis)
• Prolonged, inconspicuous pelvic pain

Typical symptoms: How Pelvic Congestion Syndrome manifests itself

Not every woman with ovarian varicosis has symptoms. However, when symptoms do occur, they can have a significant impact on life:

• Chronic pelvic pain, especially after prolonged sitting or standing
• Pain during sexual intercourse (dyspareunia)
• Increasing discomfort before menstruation
• Feeling of pressure and heaviness in the lower abdomen
• Varicose veins in the external genital area or on the thighs
• Back pain or pain in the groin
• The pain is usually dull, aching, cannot be localized precisely – and often subsides when lying down.

Diagnosis of Pelvic Congestion Syndrome: How PCS is recognized

As the symptoms are non-specific, a targeted diagnosis is crucial. The following procedures are used:

1. Medical history and clinical examination

• Detailed questioning about menstrual cycle, pain, vein problems, pregnancies
• Visible varicose veins in the genital or thigh area can provide clues
  

2. Ultrasound (duplex sonography)

• First choice: visualization of the pelvic veins and blood flow
• Very meaningful in experienced hands

3. MRI (magnetic resonance imaging)

• Visualization of deeper veins and congestion
• Particularly helpful for unclear complaints

4. Phlebography (contrast medium X-ray of the veins)

• “Gold standard”: shows exactly which pelvic veins are abnormally dilated
• Allows targeted therapy (coiling) at the same time

Treatment of PCS with VenaZiel®: minimally invasive with coiling

The modern standard therapy today is endovascular coiling – a minimally invasive procedure that VenaZiel® offers for affected women.

What is coiling?

During coiling, the diseased veins are closed from the inside using a thin catheter, usually via the groin vein. Platinum coils or sclerosing agents are used to divert the blood flow and relieve the abnormally dilated vein.

Advantages of the coiling process:

• Outpatient procedure
• No large incisions, just a small incision in the groin
• Short recovery time, hardly any pain
• High success rate of over 80-90% with the right indication
• Low complication rate

PCS therapy at VenaZiel® in Berlin: Discreet, competent and holistic

VenaZiel® offers affected women individualized care – from diagnostics to therapy and aftercare. The treatment takes place:

• Interdisciplinary: phlebology, vascular surgery, radiology
• Minimally invasive outpatient treatment in modern operating theaters at the DAYKLINIK®
• With state-of-the-art imaging and technology
• Trustworthy: gynaecological and vascular specialist advice

Frequently asked questions (FAQ) about Pelvic Congestion Syndrome

1. Is the PCS dangerous?

No, it is not a life-threatening condition – but if left untreated it can have a significant impact on quality of life.

2. How long does the procedure take?

Coiling therapy usually lasts 45-60 minutes and is carried out on an outpatient basis.

3. Is the treatment covered by health insurance?

In many cases yes – if medically indicated. We will advise you individually on the costs.

4. Can PCS recur after therapy?

In rare cases, recurrences can occur, especially if other pelvic veins are affected. Careful diagnosis prevents this.

5. Do I have to wear compression stockings afterwards?

Usually not – the coiling works mechanically and closes the vein permanently.

6. Is the treatment painful?

No, the treatment is usually performed under local anesthesia or light sedation. Most patients only report a feeling of pressure.

7. Can PCS also occur during the menopause?

It usually occurs before the menopause, but can also persist later – especially if the veins are already damaged.

Summary: Your symptoms are treatable – and you are not alone

Pelvic congestion syndrome is common but curable. If you suffer from chronic abdominal pain that no one can explain, you deserve a thorough assessment. VenaZiel® is at your side with interdisciplinary expertise – and offers a modern, effective and gentle treatment with the coiling procedure.

References

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