What is chronic pelvic pain?
Chronic pelvic pain that occurs because of pelvic congestion syndrome is often felt below the belly button in the pelvis. A number of conditions can cause chronic pelvic pain, including enlarged varicose veins in the ovaries and pelvis. In the pelvis, veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can pool in your veins, which causes them to swell. When this happens near the pelvis, it is called pelvic congestion syndrome. Women with pelvic congestion syndrome often experience pain during or following intercourse.
Pelvic congestion syndrome usually affects women who have previously been pregnant because the ovarian and pelvic veins widened to accommodate the increased blood flow from the uterus during pregnancy. After the pregnancy, some of these veins remain enlarged and fail to return to their previous size, causing them to weaken, allowing blood to pool.
What are the causes of chronic pelvic pain?
Determining the cause of pelvic pain can be complicated because there are many possibilities:
- Pelvic congestion syndrome
- Uterine fibroids
- Kidney stones
- Infected appendix
- Endometriosis
- Ovarian cysts
- Other causes
A number of diagnostic tests can be performed through minimally invasive methods to determine whether your chronic pelvic pain is a result of pelvic varicose veins. These tests include:
- Pelvic and transvaginal ultrasound
- Pelvic venogram
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
How do IRs treat pelvic congestion syndrome?
Pelvic congestion syndrome is treated with ovarian vein embolization by an IR using X-ray guidance and mild sedation. Ovarian vein embolization is a same-day treatment, which takes place in an interventional radiology suite. Through a small incision in your groin or wrist, the IR passes a small catheter through your veins to reach the enlarged pelvic veins responsible for the congestion.
The catheter allows the introduction of embolic agents, medications that seal off the vein, relieving the painful pressure. When the catheter is removed, pressure is applied to the vein. After treatment, women can return to normal activities immediately.