What is pelvic congestion syndrome and how is it diagnosed and managed?
The development of varicose veins in the pelvis, usually of the ovarian veins, is associated with a collection of symptoms contributing to the pelvic congestion syndrome. The syndrome is more common in multiparous women, and pelvic pain which worsens in association with menstruation and sexual intercourse is the main complaint. Other associated symptoms include backache, vaginal discharge, bloating and mood swings. Up to 15% of menstruating women will have varicose veins in the pelvis but many will be asymptomatic. The diagnosis is mainly one of exclusion, as similar symptoms occur with endometriosis or chronic pelvic inflammatory disease. Pelvic congestion syndrome may be suspected in the presence of varicosities of the legs and there is often pelvic tenderness on examination though but this is seldom discriminatory. Diagnostic laparoscopy may reveal distended pelvic veins and exclude other causes of pelvic pain. Venography will confirm the diagnosis. Initially, women should be manage
