Chronic pelvic pain is very common among women, accounting for up to 40% of all gynecologic office visits.

This pain can be debilitating for patients and frustrating for both patients and caregivers. There are several causes for chronic pelvic pain, with the most common being endometriosis. The second most common cause, which is often under-diagnosed but occurs in 30% of women with chronic pelvic pain, is pelvic venous congestion syndrome.

Pelvic venous congestion syndrome is essentially varicose veins in the pelvis.

This syndrome arises because of the absence of or faulty valves within the gonadal veins. This leads to reflux of blood down the gonadal veins into the pelvis, which causes these veins to dilate and can even lead to new vein formation in the pelvis. Patients present with cyclical pelvic pain that is often worse in the premenstrual period and is exacerbated by standing. Pain with intercourse or using the bathroom are also common. In addition, patients may begin to see painful varicose veins in the vulva region or upper thigh.

The workup for pelvic venous congestion begins by ruling out other causes of pelvic pain, which can be completed by a gynecologist or women’s health provider. A pelvic ultrasound followed by a pelvic MRI and/or CT scan can then be used to evaluate for large veins in the pelvis and enlarged gonadal veins.

Gonadal Vein Embolization is a procedure for the treatment of chronic pelvic congestion syndrome. Chronic pelvic pain related to chronic venous congestion can be evaluated and treated by interventional radiologists at the RIA Endovascular clinic by calling 720-493-3406.

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