By: The Vein Treatment Center of NJ | Dean H. Wasserman, MD, FACS, RVT, FACPh
Paramus, NJ
Dear Patient,
Awareness of the existence of Pelvic Congestion Syndrome is
just recently blossoming. The two conditions of Pelvic Congestion and
Pelvic Dumping Syndrome are closely related and refer to the presence
of varicose veins in the abdomen and pelvic area. The former describes
the localized symptoms of distended varicosities such as "atypical"
pattern of abdominal pain, frequent urinary tract infections (due to
compression on the urinary tubes) and the development of vulvar
varicosies in pregnancy. The Dumping variation also can manifest by
lower extremity varicose veins, especially in the face of normal groin
saphenous functioning. The most typical pattern of leg veins involves
the "highest" source of weakness in the superficial (surface)
saphenous vein at the groin level.
Anatomically, these syndromes originate from either the
"Gonadal" veins which are located at the level of the renal (kidney)
vein level and/or from the "Internal Iliac" vein branches in the lower
pelvis.
Accurate diagnosis begins with awareness of these
conditions, and careful history taking from the patient. Many affected
patients have been treated for a variety of vague conditions such as
irritable bowel syndrome and have been dismissed undiagnosed after
having gone through a battery of negative testing.
As is the case for the vast majority of diagnoses,
accurate identification is expected to be reached by a very
comprehensive history taking, including a "review of symptoms"
pointedly directed to cover remote or mild symptoms that many patients
may not feel important enough to spontaneously report.
Ultrasound is not very accurate in diagnostic sensitivity,
while CT scan and MRI with/or without dye injection are of moderate
diagnostic value.
When the working diagnosis is Pelvic Congestion/Dumping
Syndrome, optimal approach is local anesthesia , Venogram
