Pelvic Congestion Syndrome

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Pelvic Congestion Syndrome

An estimated one-third of women experience chronic pelvic pain during their lifetime, and one common cause is ovarian vein or pelvic varices. These abnormally dilated blood vessels are the counterparts of varicose veins, but they are located within the pelvis and not visible during external examinations, so they may be easily overlooked.

In some cases, pelvic pain can be caused by May-Thurner Syndrome. In this condition the large vein in the pelvis is compressed by the adjacent artery causing pelvic pain and in some cases leg swelling

More about the Process and Procedure

Diagnosis of the cause of pelvic congestion syndrome can be tricky, and may involve the use of ultrasound, computed tomography (CT) scans, magnetic resonance imaging (MRI), or pelvic venography to locate the abnormal veins. If these swollen blood vessels are found to be the cause of chronic pelvic pain, the resulting pelvic venous congestion syndrome can be treated via a non-surgical, minimally-invasive procedure to embolize the pelvic varices by blocking blood flow to them.

During the procedure, a catheter is introduced by an interventional radiologist into a vein either at your groin or neck. It is then guided using fluoroscopy to the precise location of the problem. Contrast dye may be injected to make it easier to see the varices to be treated. An embolizing agent is then injected through the catheter to close the abnormal veins while not affecting normal tissue. These agents can include coils to completely block large blood vessels, liquid sclerosing agents to cause vessels to collapse, or liquid glues to block swollen vessels.

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What To Expect

If your doctors advise this procedure, it will be performed on an outpatient basis by MTV IR interventional radiologists, and you can usually go home the same day. Medical staff will insert IVs and other monitors to measure your vital signs, and then your groin area will be shaved and washed with a special soap. After a numbing medication is injected into the area, the interventional radiologist will insert the catheter into the large vein there and guide it into place X-ray fluoroscopy. You will be moderately sedated during the procedure. In most cases the procedure takes about 30 minutes.


After the procedure, the catheter in your groin is removed and you will be asked to lie flat while the doctors monitor your progress. You may experience some mild pain or discomfort after the procedure, which will be controlled by medication. You will probably be released from the hospital after about 4 hours, and after your release you should avoid driving for 24 hours, limit your activities, and avoid physical exertion or heavy lifting for several days. Full recovery usually takes just a few days. Symptoms caused by the pelvic varices should become substantially reduced within a few weeks.

A Few Of Our Cases

Image A
This is a venogram of the left side of the pelvis. Contrast is injected on the in the left common femoral vein (on the right side of the image) and large collaterals are seen diverting the blood to the right side of the pelvis due to a near blockage in the left common iliac vein. This is called May-Thurner Syndrome and can cause a diverse series of symptoms including pelvic pain, migraines, pain with intercourse, leg selling or pain, postural orthostatic tachycardia syndrome (POTS), and blood clots.
Image B
This is a venogram obtained from the same location as that in Image B after the placement of a special venous stent to help keep the left common iliac vein open. The collateral veins have now resolved and the patient’s symptoms improved markedly. Intravascular ultrasound is used to precisely determine the size of the vein and the size of the stent used in the treatment.

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About MTV IR

MTV IR is a leading interventional radiologist in the Dallas/Fort Worth area. With decades of experience Dr. Travis Van Meter has developed one of the most advanced IR clinics in Texas with leading edge technology. Specializing in Women’s Health, Men’s Health, and Liver Cancer Therapies, you can feel safe with the most trusted and knowledgeable physicians in DFW.

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