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  • Q&A with Australian Health Practitioners

    Could my chronic pain be attributed to pelvic congestion syndrome?

    Hi, I have had chronic groin and pelvic pain for several years, I have had numerous scans and tests including std tests, internal pelvic examinations and ultrasounds and no doctor has ever been able to tell me why I suffer continuously. I have recently had a scan which has mentioned pelvic congestion. could this be the reason for my pain and irritation?
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  • 1

    Thanks

    Dr Joseph Jabbour

    Gynaecologist, Obstetrician, Obstetrician and Gynaecologist

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the ... View Profile

    Pelvic Congestion Syndrome can certainly be a cause to your pain. This is a poorly understood condition and certainly one that should be reached by a process of elimination. The main issue is that these findings can be nonspecific and are not too uncommon in women. This makes the diagnosis and the treatment of this condition challenging.

    The questions I have for you are:

    1- Do you suffer from painful periods?

    2- Do you have pain with intercourse?

    3- Do you have any bladder or bowel symptoms?

    If you have not seen a gynaecologist, then I would recommend you do so. I would advise you to have a laparoscopy (key-hole surgery) to rule out more common causes for chronic pelvic pain such as chronic infection, adhesions, or endometriosis. 

    Once the other conditions are excluded, the treatment of Pelvic Congestive Disorder is either medical or surgical, both of which have mixed results. Speak to your gynaecologist about these options. In my experience, most women presenting with chronic severe pain like yourself have another condition such as endometriosis.

    All the best

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  • 1

    Thanks

    Dr Shannon Thomas

    Vascular Surgeon

    Pelvic Congestion Syndrome may be the cause of your pelvic pain. However one must keep in mind that there are many causes of pelvic pain. 

    Pelvic Congestion Syndrome is suggested when there is reversed blood flow and thus enlargement of the ovarian veins or veins of the pelvis. This leads to congestion of the pelvic organs and hence pain.

    I usually see patients with pelvic pain who are referred from their General Practitioner or Gynaecologist where a diagnosis of Pelvic Congestion Syndrome is suspected. Patients usually describe one or more of excessively painful periods, pain with sex, blood in the urine, varicose veins on the legs or labia and pain in the flanks/loins.

    An Ultrasound and MRI of the abdomen are usually required to confirm the diagnosis. This ensures that there is no blockage or narrowing of any other veins that may cause a similar picture.

    Once confirmed, an angiogram is performed via a small needle in the upper thigh vein. The culprit veins can then be accessed via catheter and wire and coils placed in the problematic vein. The procedure can be performed as a day case under local anaesthetic. Most patients experience some flank pain in the post operative period, however do find a significant improvement in total pain experience over the subsequent weeks.

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