Endovascular Therapy For Pelvic Congestion Syndrome

Joseph J. Naoum
In: Methodist DeBakey Cardiovascular Journal · 2009 · vol. 5(4) , pp. 36–38 · doi:10.14797/mdcj-5-4-36 · PMID:20143594 · W2051365695
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Pelvic congestion syndrome, characterized by pelvic pain, heaviness, and varicosities, is a common cause of chronic pelvic pain, often linked to ovarian vein incompetence.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This review describes pelvic congestion syndrome (PCS) as a cause of chronic pelvic pain associated primarily with ovarian vein incompetence, detailing typical symptoms such as pain that is worse pre- or during menses, aggravated by prolonged standing and intercourse, and accompanied by heaviness, bladder urgency, and labial varicosities. It summarizes the clinical presentation and situates PCS within the broader differential diagnosis of chronic pelvic pain, noting prior descriptions of the PCS–CPP association and citing data that PCS can account for a substantial portion of pelvic pain cases alone or alongside other pelvic pathologies. A limitation is that, as a review article, it synthesizes existing literature rather than presenting new patient data or outcomes. Relevance to endometriosis: the paper lists endometriosis among common causes of chronic pelvic pain in its differential context, though its main focus is endovascular therapy for pelvic congestion syndrome.

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Abstract

Clinical PresentationPelvic congestion syndrome (PCS), a condition associated primarily with ovarian vein incompetence, is manifested by pelvic pain of variable intensity that is heightened before or during menses and aggravated by prolonged standing, fatigue, and intercourse. Women may also report pelvic or perineal heaviness and bladder urgency and often will complain of labial varicosities and engorgement that worsens with standing.1, 2 It is not infrequent to elicit these complaints and symptoms after careful evaluation of a patient who presents with varicose veins in the proximal lower extremity.The association of PCS with chronic pelvic pain was first described by Topolanski-Sierra in 1958.3 Chronic pelvic pain (CPP) accounts for approximately 10% of outpatient gynecologic visits. Common causes of CPP include ovarian varicocele, endometriosis, pelvic adhesions, atypical menstrual pain, urologic disorders, irritable bowel syndrome, and psychosomatic conditions.4 More recent studies have demonstrated that up to 30% of patients with CPP have PCS as a sole etiology of their pain, and an additional 12% have PCS in combination with another pelvic pathology.5, 6
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Endovascular Therapy for Pelvic Congestion Syndrome Review Articles Abstract Clinical Presentation Pelvic congestion syndrome (PCS), a condition associated primarily with ovarian vein incompetence, is manifested by pelvic pain of variable intensity that is heightened before or during menses and aggravated by prolonged standing, fatigue, and intercourse. Women may also report pelvic or perineal heaviness and bladder urgency and often will complain of labial varicosities and engorgement that worsens with standing.1, 2 It is not infrequent to elicit these complaints and symptoms after careful evaluation of a patient who presents with varicose veins in the proximal lower extremity. The association of PCS with chronic pelvic pain was first described by Topolanski-Sierra in 1958.3 Chronic pelvic pain (CPP) accounts for approximately 10% of outpatient gynecologic visits. Common causes of CPP include ovarian varicocele, endometriosis, pelvic adhesions, atypical menstrual pain, urologic disorders, irritable bowel syndrome, and psychosomatic conditions.4 More recent studies have demonstrated that up to 30% of patients with CPP have PCS as a sole etiology of their pain, and an additional 12% have PCS in combination with another pelvic pathology.5, 6

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Condition tags

endometriosischronic_pelvic_painirritable_bowel_syndrome

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