Author:

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}