I Think I Have Pelvic Congestion Syndrome. What Next?

If you think you might have Pelvic Congestion Syndrome (PCS) due to pelvic pain that is associated with enlarged veins in the groin, buttocks or vaginal area, or pain that worsens after prolonged standing or after intercourse, you need to be evaluated by a vein specialist who has experience in diagnosing and treating PCS.

The first step in diagnosing PCS is a thorough medical history and physical exam. Your vein specialist will ask you questions about the nature and timing of your pain, and examine you for outward signs of vein disease. If you have not had an ultrasound of your pelvic area, your doctor may recommend this to evaluate for enlarged pelvic veins. A CT scan or MRI with contrast can also be helpful in finding enlarged pelvic veins. The definitive way to diagnose and treat PCS is with a venogram, which is a test that uses intravenous dye and x-ray machines to look for the specific veins that are dilated and causing your pelvic pain. Once the diseased veins are identified, small coils and/or medication can be injected directly into the veins to cause them to shut down and divert the blood to healthier veins. This can be done in the office of an experienced interventional radiologist who has the proper equipment. Not all vein doctors specialize in PCS, so it is important to find one that is comfortable with the diagnosis and treatment of this condition.