UK HealthCare

What to Know About Chronic Pelvic Pain

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The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Merve Ozen, M.D., assistant professor of radiology and surgery in the Uterine Fibroid Program at UK HealthCare.

LEXINGTON, Ky. (May 9, 2022) ­ For many women, pelvic pain is an uncomfortable, frustrating part of their everyday life. This pain can be caused by pelvic venous congestion syndrome (PVCS), also known as pelvic venous disease.

In PCVS, the pain is felt below the belly button and can worsen during menstrual cycles or just after a long day of sitting or standing. PVCS often overlooked or can be difficult to diagnose because there are various other reasons that can cause pelvic pain.

PCVS occurs mostly in women who have experienced pregnancy or who have vein compression syndromes. In the pelvis, veins have one-way valves that help keep blood flowing toward to the heart. During pregnancy, ovarian and pelvic veins widen to accommodate the increased blood flow from the uterus. If the valves are weak or damaged, and the veins fail to return to their normal size after pregnancy, the blood backs up and the veins become “congested,” which can be painful. Other symptoms include pain on one or both sides of the pelvis, a feeling of “fullness” in the legs or incontinence due to the enlarged veins pressing the bladder or rectum.

If your doctor suspects you have PCVS, they will perform some tests to determine if the pain if caused by venous congestion. These can include pelvic or transvaginal ultrasound, an MRI or a CT scan. They might also perform a pelvic venogram, a test in which a special dye is injected into the veins so they will show up on an X-ray.

Treatment for PCVS is determined by the severity of the congestion. For PCVS treatment, hormonal medications prescribed by your gynecologist can reduce the pelvic congestion. If this is ineffective, then PVCS can be treated with a minimally invasive procedure called ovarian vein embolization. Using interventional radiology, a catheter is inserted through a small incision and seals off the vein, relieving the painful pressure. Intravenous medications are provided for comfort and relaxation, and patients go home the same day. Typically, patients can return the work the next day and resume normal activities in a week.

If you are experiencing pelvic pain, know that relief is possible. Talk to your gynecologist about your symptoms and treatment options.

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