Pelvic congestion syndrome (PCS) is a disease that is often undiagnosed in women with pelvic pain. Chronic pelvic pain affects approximately 15% of premenopausal women in the United States. The lack of diagnosis seems to be related to limited awareness of this disease process by both physicians and patients, coupled with incomplete literature.
PCS usually occurs in premenopausal, mutiparous women. Chronic pelvic pain is diagnosed after pain has been present for at least 6 months. Patients often report lower pelvic pain, dyspareunia, postcoital pain, and/or bladder irritability or urgency. This pain is exacerbated by prolonged standing and can radiate to the thigh or buttocks. This pain is worse at the end of the day or with standing.
Pelvic venous disease is prevalent in patients with chronic pelvic pain. Women who have persistent intermittent pain with no other underlying pathology should be considered for treatment, which consists of sclerotherapy, embolisation, and iliac venous stenting. Interventional radiologists are familiar with the symptoms, workup and treatment of this disease, and thoughful treatment can significantly improve the patients quality of life.
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