Professor Ramon Varcoe

Pelvic Congestion Syndrome

Approximately one third of women will experience chronic pelvic pain during their lifetime. A large number of possible diagnoses exist including gynaecological disorders such as fibroids, endometriosis and ovarian tumours which need to be excluded. Dilated pelvic and ovarian veins are often responsible for these symptoms in a condition termed Pelvic Congestion Syndrome.

Pelvic Congestion Syndrome is caused by refluxing veins which result in high pressure blood stretching the vein wall. This is a similar process to lower limb varicose veins however due to their hidden location within the pelvis they often go undiagnosed.

Diagnostic investigations with ultraound and pelvic CT scan are usually followed by a pelvic venogram. This is an outpatient test whereby contrast dye is injected into the ovarian and pelvic veins and then observed with x-rays to confirm the diagnosis.

Definitive treatment for this condition is catheter based and performed under local anaesthetic. The ovarian and pelvic veins which are refluxing are intentionally occluded using a combination of coils and sclerotherapy agents. Patients are kept in hospital overnight as abdominal pain is common for a few days afterward. The treatment successfully relieves the symptoms in 80% of sufferers.

Professor Varcoe has a special interest in this condition and sees many patients with the disorder.