Pelvic congestion syndrome, also known as vulvar varicosities or ovarian reflux, is a common cause of chronic pain in up to 40% of women. PCS is caused by dilation of the ovarian and Pelvic veins in the lower abdomen. The typical age range when a woman develops PCS is from age 20-45 years old.
Pelvic or low back pain that increases after long periods of sitting or standing
Pain after intercourse (dyspareunia)
Pain before the menstrual cycle
Visible varicose veins around the vulva, vagina, inner thigh, and sometimes the buttocks and legs
Painful menstruation (dysmenorrhea)
Abnormal bleeding during menstruation
Swelling of the vagina or vulva
Abnormal tenderness, increased urination, hip pain, and dragging sensation
50% of women with PCS have cystic ovaries
Transvaginal Ultrasounds (the Gold-Standard test)
Magnetic Resonance Imaging (MRI)
Computed Tomography (CT) will provide visualization of incompetent veins and allow for a proper treatment plan
Pelvic Venography is used to provide a definitive diagnosis and provide treatment at the same time
May-Thurner Syndrome ( Compression of the left Iliac vein by the right iliac artery )
Left renal stenosis
Endometriosis, or scarring.
Medications such as NSAIDs or non-steroidal anti-inflammatory drugs, chronic pain medications such as gabapentin and amitriptyline may be used to treat PCS.
Surgical intervention: Ovarian / pelvic vein coil embolization treatment. A catheter is placed into the vein wherein coil emboli (Small medical-grade spheres) are placed into the affected vein blocking the flow of blood in that area, allowing the blood to reroute through healthier veins. This procedure can be done in an outpatient setting and has a 98% success rate and a decrease in pain of 83% of patients in long-term follow-up.
Radiofrequency closure, also known as radiofrequency ablation, addresses the venous reflex disease that often causes varicose veins. It serves as an alternative to traditional vein stripping, which requires invasive surgical removal of the diseased veins. Instead, radiofrequency ablation uses heat energy to prompt the closure of diseased veins.
The surgeon starts by numbing the area with a topical and local anesthetic. Then, by way of a small incision, he or she passes a catheter or similar tool into the affected vein. The catheter serves as a channel through which the surgeon introduces an electrode.
When the surgeon pulls back on the catheter to expose the end of the fiber or electrode, energy passes into the vein as heat. This heat shrinks the collagen in the vein wall, which in turn causes the vein to shrink and close. The surgeon then removes the catheter and the patient’s body proceeds to heal the closure by rerouting blood to healthy veins.
can occur without warning signs Also felt as discomfort in the affected area including Swelling and pain the affected leg. Additionally, redness and warmth along the vein where the clot is found.
Coagulation of blood is an important process that helps to prevent excessive bleeding during injury. However, in the absence of Injury, when the blood is not flowing properly or if it pools in the veins the platelets in the blood that help with coagulation can stick together and cause it to clot.
a. Inactivity- During a long flight or drive b. Damage to a vein c. Cancer or other diseases that cause your blood to clot more easily d. Medications e. Hormones
a. Age b. Obesity c. Pregnancy d. Family History of DVT e. Having a catheter placed in a vein f. Deep vein injury g. Smoking
Your vascular surgeon will ask questions about your symptoms and medical history as well as performing a thorough physical examination.
a. Duplex ultrasound to check the flow of blood in the area of the perceived clot. A Venograph can also be done by injecting a contrast dye into the vein under x-ray to see where the dye is allowed to pass through. The X-ray will show a mapping of your veins and show the area where the contrast dye was unable to pass through. Although DVT’s can generally be diagnosed by duplex ultrasound, venography is another option Western Vascular Institute has available to confirm the diagnosis.
Most often a Deep Vein Thrombosis or DVT can be treated by a medication known as blood thinners or anticoagulants. These medications help prevent the blood from clotting and over time reduce the size and consistency of the clot.
Maintain good overall health including a healthy diet and staying physically active will help reduce the risk of a DVT. It is likewise important to maintain a healthy weight and make sure to follow up with your vascular surgeon to discuss the possibility of long-term blood thinner medications.
Varicose Veins are veins that have become enlarged and twisted. They can occur anywhere on the body, but most often appear in the arms and legs. Some cases of varicose veins are solely cosmetic, but often they produce pain and discomfort or lead to other circulatory problems. Possible complications include ulcers near the ankles, bleeding, or blood clots.
In healthy leg veins, tiny valves keep blood from pooling in the lower body. When these veins become stretched with age, the valves fail and blood accumulates.
Our Board-certified vascular surgeons have extensive experience treating varicose veins.
Many different doctors treat varicose veins, so why should I see a vascular surgeon specifically?
Many doctors treat varicose veins, but vascular surgeons are specifically trained and board certified to treat such disorders. Vascular surgeons only treat venous and vascular disorders from the time they graduate medical school. These specialists spend their entire career focusing solely on venous and vascular diagnosis, and treatment.
This amount of dedication, and training provides them with a unique, unbiased, expert perspective on causes, treatments and differential diagnosis of these diseases. Differential diagnosis meaning, that even though an individual may have varicose veins, this does not necessarily mean that the varicose veins are the underlying problem. Vascular surgeons are best able to diagnose these underlying problems and are the only physicians that can provide all available treatment options for venous and vascular diseases.
Our doctors have over 65 years of experience and have dedicated their careers to help treat patients with venous and vascular disease. Without a doubt, Western Vascular Institute has the best vascular surgeons in Arizona.
At least 20-25 million Americans suffer from varicose veins which are often inherited and most commonly affect women. This infographic illustrates the signs, symptoms and treatments available at Western Vascular Institute.