The Pelvic Congestion Syndrome
This condition is encountered exclusively in women during and after pregnancy. Normally, blood from this part of the body is drained back into the heart by veins that are branches of pelvic veins such as the internal iliac vein and the ovarian veins. The uterus is not far from these veins, and during late stages of any pregnancy, because of the compression of these veins by the growing uterus, all the veins in the area are exposed to increased venous pressures, resulting in excessive blood congestion.
Then transmitted to the lower veins of the vulva and vagina, the veins may bulge, causing discomfort and pain. Occasionally hemorrhoids will present themselves for the same reasons. Fortunately, however, in most cases after delivery, most of these painful bulging veins will disappear. It is possible that after subsequent pregnancies these veins will be permanently present and will cause discomfort and pain while standing and mainly around the monthly periods.
Many women may also complain of lower abdominal pain and some will complain of pain during sexual relations. While the syndrome is rare, it is unfortunate that is not easily recognized by the gynecologist and these women will go from physician to physician for help.
Once the condition is diagnosed or suspected- the patient is referred to an interventional radiologist. Most major community hospitals and certainly university hospitals have the needed equipment for such tests. The radiologist will correctly diagnose the problem by injecting a dye through a catheter inserted in the main vein of the leg in the groin. After positively diagnosing the offending and leaking vein the radioloigist will use, through the same catheter, either foam or special coils to close off the vein through which blood is flowing downhill filling up the veins of the vulva and vagina.
Occasionally, concomitant injection of the visible vulval veins has to be done as well. This form of treatment is usually very successful and will avoid any surgical intervention.
