Pelvic Congestion Syndrome Treatment


What is Pelvic Congestion Syndrome, and how does it occur?

Ovarian Vein Reflux or Pelvic Venous Disease is a medical condition that has been underdiagnosed and misunderstood. It is quite prevalent, affecting 10-15% of all referrals to gynecologists and pain clinics.

Pelvic Congestion Syndrome is a condition in which varicose veins develop in the pelvis. These engorged veins result from faulty valve function on blood flow pathways. Vascular varicosities may be caused by multiple pregnancies, as well as anatomic abnormalities such as May-Thurner Syndrome.

The most common symptom of Pelvic Congestion Syndrome is pelvic pain that gets worse when you stand. Blood cannot flow properly when you are upright because the faulty vein valves prevent it from doing so. As a result, continual, deep, severe, and gradually increasing discomfort becomes worse as the day goes on.


  • Pain in the pelvis
  • Menstrual pain before or during your period
  • Urinating suddenly becomes urgent
  • Pain with intercourse
  • Buttocks, thighs, vulva (external genitals) presenting abnormal or enlarged veins.

What is the treatment for Pelvic Congestion Syndrome?

At MIVA, we recognize that “living with the agony” for months is not an option, therefore we take a distinct approach to pelvic pain in women. All potential sources of your discomfort are investigated during our pelvic pain program, including uterine, endometrial, cervical, vascular, and neurological factors. Once we have discovered the true underlying cause of the problem, we can start treating it effectively with therapies that have a proven history of working.

At MIVA, we employ ovarian vein embolization as our primary treatment approach. This is a minimally invasive procedure, and the patient recovery period is significantly shorter than other more invasive options.

We may perform a venogram with intervention to potentially place a coil to limit the blood supply to the ovarian artery. This would be performed after imaging, diagnosis, and consultation with our provider.

What is a venogram with intervention?

“Veno” refers to vein, and “Gram” refers to picture. Using ultrasound guidance, our specialists access your veins and utilize X-ray imaging to “see” the veins and evaluate their functionality to determine the best therapy strategy. With the help of ultrasound guidance, a hollow needle is used to access a vein in either your arm, leg, or neck after determining the correct route. A wire is then pushed into the vein using X-ray assistance.

Finally, depending on your requirements, the interventionalist may consider the following actions:

  1. Balloon angioplasty is a type of minimally invasive treatment used to repair or widen veins and arteries. Specialized miniature balloons can be inflated to unclog blockages or de-compress narrowed vessels.
  2. Stent placement: If a vein cannot stay open on its own, stents, known as tubular metal scaffolds, can be used to keep it open.
  3. Embolization: If necessary, we can utilize coils or plugs to close off an inactive vein.

Intravascular ultrasound (IVUS) may also be used to look at the veins from the inside to help evaluate and guide treatment decisions in some circumstances.

MIVA offers a variety of treatments for chronic pain that are completed as outpatient procedures at its facility or in a local hospital. The surgical procedure may be done under local or general anesthesia, depending on the disease being treated. In many situations, it can be done while semi-conscious. Recovery time is short since there are no incisions. The major restriction is that no heavy lifting (defined as > 15 lbs.) for five days after the procedure is permitted. Following therapy, blood thinners may be required on a temporary basis.