Is pelvic congestion syndrome related to hemorrhoids?

I have had hemorrhoids for a number of years, and now am beginning to feel more pelvic pain than before. What is pelvic congestion syndrome and can hemorrhoids cause it?

Answers from doctors (2)


Vascular Institute of Chattanooga

Published on Aug 18, 2019

Pelvic congestion syndrome (PCS) is an entity in which the valves in the veins inwoven that drain the ovaries and the pelvis become overwhelmed, causing ovarian vein dilation and stasis.

It is most commonly seen in women who have been pregnant multiple times and are still premenopausal. It is thought to be due to the increased loads placed on the pelvic vein during pregnancy. It is unclear as to why these findings are associated with chronic pelvic pain in some women and not others.

The pain is usually unilateral but can be bilateral. The patient may note sharp exacerbations of pain, dysmenorrhea, pain with intercourse and urinary urgency.

PCS can also cause varicosities on the abdomen and pelvis of women as well as in their vulva.

There are multiple modalities for diagnosis. It should be noted that there are multiple causes of pelvic pain, and these should be ruled out prior to seeking treatment for PCS.

Diagnosis of PCS is most accurate with venography, in which a catheter is inserted into the ovarian vein via the groin or neck and a dye study is performed. If it is positive, the vein can be embolized and closed down with small metal coils at the same time of diagnosis. This is therapeutic and brings significant improvement to most with PCS.

Persistent painful varicose veins can undergo sclerotherapy (injection of foam directly into the painful vein) if necessary.

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Answered by Vascular Institute of Chattanooga

Pelvic congestion syndrome (PCS) is an entity in which the valves in the veins inwoven that drain the ovaries and the pelvis become overwhelmed, causing ovarian vein dilation and stasis.

It is most commonly seen in women who have been pregnant multiple times and are still premenopausal. It is thought to be due to the increased loads placed on the pelvic vein during pregnancy. It is unclear as to why these findings are associated with chronic pelvic pain in some women and not others.

The pain is usually unilateral but can be bilateral. The patient may note sharp exacerbations of pain, dysmenorrhea, pain with intercourse and urinary urgency.

PCS can also cause varicosities on the abdomen and pelvis of women as well as in their vulva.

There are multiple modalities for diagnosis. It should be noted that there are multiple causes of pelvic pain, and these should be ruled out prior to seeking treatment for PCS.

Diagnosis of PCS is most accurate with venography, in which a catheter is inserted into the ovarian vein via the groin or neck and a dye study is performed. If it is positive, the vein can be embolized and closed down with small metal coils at the same time of diagnosis. This is therapeutic and brings significant improvement to most with PCS.

Persistent painful varicose veins can undergo sclerotherapy (injection of foam directly into the painful vein) if necessary.

Published on Jul 11, 2012


Advanced Vein Center

Published on Dec 27, 2016

Pelvic congestion syndrome is generally not related to hemorrhoids. PCS is pelvic pain that has been present for more than 6 months.

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Answered by Advanced Vein Center

Pelvic congestion syndrome is generally not related to hemorrhoids. PCS is pelvic pain that has been present for more than 6 months.

Published on Jul 11, 2012


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