Pelvic compression syndrome

Pelvic Compression Syndrome, also known as Pelvic Congestion Syndrome (PCS), is a medical condition characterized by chronic pain in the lower abdomen and pelvis. It is often associated with the presence of varicose veins in the pelvic region, which result from the malfunctioning of valves in the ovarian veins. This condition is more commonly observed in women of reproductive age, particularly those who have had multiple pregnancies.

Causes and Risk Factors

The primary cause of Pelvic Compression Syndrome is the reflux or backward flow of blood through the ovarian veins, which leads to increased pressure and the formation of varicose veins in the pelvis. Several factors can contribute to the development of PCS, including:

• Pregnancy: The increased blood volume and hormonal changes during pregnancy can lead to the dilation of veins.
• Hormonal fluctuations: Changes in hormone levels can affect vein walls, making them more prone to dilation.
• Venous insufficiency: A condition where veins have problems sending blood from the limbs back to the heart.
• Polycystic Ovarian Syndrome (PCOS) and other conditions that affect pelvic blood flow.

Symptoms

Symptoms of Pelvic Compression Syndrome can vary but often include:

• Chronic pelvic pain that worsens with standing or during the latter part of the day.
• A feeling of fullness or heaviness in the pelvis.
• Pain during or after intercourse.
• Varicose veins around the buttocks, vulva, or thighs.
• Urinary or bowel symptoms.

Diagnosis

Diagnosis of PCS involves a combination of patient history, physical examination, and imaging studies. Techniques used to diagnose PCS include:

• Ultrasound: Particularly transvaginal ultrasound, to visualize the pelvic veins.
• Venography: An invasive test where a contrast dye is injected into the veins to visualize blood flow and vein structure.
• Computed Tomography (CT) or Magnetic Resonance Imaging (MRI): These imaging modalities can provide detailed images of the pelvic veins.

Treatment

Treatment options for Pelvic Compression Syndrome aim to alleviate symptoms and may include:

• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain, and hormonal therapies to reduce vein dilation.
• Endovascular therapy: Procedures such as ovarian vein embolization, where a substance is injected into the veins to close them off and relieve pressure.
• Surgery: In severe cases, surgical removal of affected veins may be considered.

Lifestyle changes, such as weight management and the use of compression garments, can also help manage symptoms.

Prognosis

With appropriate treatment, many individuals with Pelvic Compression Syndrome can achieve significant relief from symptoms. However, the condition can be chronic and may require ongoing management.