Relief From
Pelvic Congestion Syndrome
Dallas Texas

Put a stop to
your pelvic pain.

Find relief with a
Vascular Specialist
in Dallas, Texas!

Put a stop to your pelvic pain.

Find relief with a Vascular
Specialist in Dallas, Texas!

Pelvic Congestion Syndrome
Treatment Dallas Texas

Pelvic congestion syndrome occurs when blood in the pelvis has trouble returning to the heart, causing one or more pelvic veins to enlarge. Enlarged pelvic veins can cause ongoing pain, bloating, and visible bulging veins on the pelvis, buttox, or legs. [1] Treatments are available for pelvic congestion syndrome that relieve pain and discomfort, [2] and may also reverse the unwanted cosmetic changes that are associated with enlarged pelvic veins.

At Interventional and Vascular Care, we provide a full suite of diagnostic and treatment services to help you overcome pelvic congestion syndrome and put a stop to your pelvic pain.

Pelvic Congestion Syndrome Doctor in Dallas, TX

Dr. Aaron Fritts, MD

Interventional & Vascular Specialists

Dr. Aaron Fritts is a board-certified Vascular & Interventional Radiologist that specializes in pelvic congestion syndrome in Dallas, TX. Dr. Fritts is well-versed in vascular conditions, and has found his passion in providing minimally invasive treatment for individuals suffering from venous disease. He was recently selected as a SuperDoctors Rising Star and has been voted one of D-Magazine’s best doctors in Dallas. Read full bio.

Dr. Aaron Fritts Interventional and Vascular Care Google Review Score
Pelvic congestion syndrome doctor Aaron Fritts in Dallas, TX interventional vascular specialist

“From the moment I setup the initial appointment to speak with Dr. Fritts, to after my final procedure, the entire staff was phenomenal.”

– Erin in Dallas, TX

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“Dr. Fritts gave me all the time I needed to understand and feel comfortable with the procedure…He has a healer’s way about him. Highest recommendation.”

– Rod in Dallas, TX

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Relief From Pelvic Congestion Syndrome in Dallas, TX

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Living With Pelvic Congestion Syndrome

Two main issues cause the pooling of blood in the pelvic veins during pelvic congestion syndrome. [3]

(1) Sometimes the pelvis veins are partially blocked. This blockage is often caused by a body part squeezing the vein and reducing the amount of blood that can flow back to the heart. Depending on the location of the squeezing, these obstructions may have medical names such as “May Thurner Syndrome”, “Nutcracker Syndrome” or “retroperitoneal mass.” [4]

(2) The pooling of the blood can also be caused by poorly functioning veins. Veins have valves that only allow blood to flow one way: back to the heart. If the valves become damaged or the vessel widens to prevent proper valve function, then blood may flow backwards (reflux). This backward flow leads to blood buildup that may permanently cause blood to pool in the pelvic veins. [5]

Diagram showing where pelvic congestion syndrome occurs and what anatomy is affected
Pelvic vein congestion sometimes causes no symptoms. These people are considered “asymptomatic” and don’t need treatment. When congestion causes pain and discomfort, the patient may have pelvic congestion syndrome. However, there are many different conditions that can also cause the same symptoms. Collectively, these symptoms are called “Chronic Pelvic Pain.” Common urinary tract infections, for example, can also cause chronic pelvic pain, but such patients would probably not have pelvic congestion syndrome. [6]

Diagnosis of Pelvic Congestion Syndrome

Since there are so many possible conditions, it can be difficult for clinicians to determine the cause of chronic pelvic pain. Many patients with pelvic congestion syndrome are never diagnosed and their chronic pelvic pain and other symptoms continue. [7] Complete diagnosis of pelvic congestion syndrome requires imaging the pelvic veins and specialized tests to rule out the many other possible causes of chronic pelvic pain. [6] For these reasons, a Vascular Specialist is often required to make a proper pelvic congestion syndrome diagnosis.

Symptoms of Pelvic Compression Syndrome

Woman with pelvic congestion syndrome doubled over with chronic pelvic pain

Chronic Pelvic Pain

Persistent pain is the most common and prominent symptom reported for pelvic congestion syndrome. This pain usually feels achy and dull. It originates in the pelvis area, and the intensity does not increase or reduce with any cycle. Pain may worsen during menstruation, after sex, during prolonged standing, while lifting heavy objects, and at the end of the day. [4]
Woman struggling with headache caused by pelvic congestion syndrome

Bloating, Discomfort, & Nausea

Individuals with pelvic congestion syndrome commonly suffer from feelings of pelvic heaviness, bloating, urinary urgency, nausea, and general discomfort. Pain and other discomforts caused by pelvic congestion syndrome may also lead to some indirect symptoms, such as anxiety, depression, and headaches.

Leg veins affected by pelvic venous congestion syndrome

Visible Vein Disease

Since the pelvic veins are directly connected to the veins of the neighboring body parts, the blood pooling can cause other visible vein issues. The main issue is overly-enlarged veins that bulge at the surface of the skin. These bulging veins can occur at the vulva, labia, rectum (called hemorrhoids), ovaries, buttocks, and legs (called varicose veins). [9]

Risk Factors for Pelvic Congestion Syndrome

There are a few factors that increase the odds of developing pelvic congestion syndrome. Patients with unusual anatomy that squeezes a pelvic vein, such as the May Thurner and Nutcracker syndrome, are at a higher risk of having pelvic congestion syndrome. Pregnancy has been shown to increase the chances of developing pelvic congestion syndrome. Women with multiple pregnancies have an even higher chance of developing the syndrome. Researchers have theorized that hormone patterns and estrogen therapy may increase risk as well. Some additional risk factors include prior poorly functioning veins, obesity, and careers that demand significant standing or lifting. [10]

Relief From Pelvic Congestion Syndrome in Dallas, TX

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Treatment With Pelvic Vein Embolization

Most doctors turn to pelvic vein embolization as their primary option for relieving pelvic congestion syndrome. [4, 7, 9] Other names for this procedure include ovarian vein embolization and gonadal vein embolization. The goal of pelvic vein embolization is to seal off poorly functioning veins to restore normal blood flow in nearby healthy veins. The embolization procedure does this in a minimally invasive way.

The patient is given local anesthesia or conscious sedation to maximize comfort. A tiny tube is usually inserted into a leg or neck vein. This tube is navigated to the damaged and unneeded pelvic veins. The doctor delivers medically designed liquids, foams, coils, plugs, or a combination of components that seal off these veins. If a necessary vein is being squeezed, the doctor might also deliver a metal scaffold called a stent that will hold that vein open. [4] Since the procedure is so elegant and causes so little harm, the patient can usually walk and go home the same day.

Pelvic vein embolization is well-established in the relief of pelvic congestion symptoms, and doctors commonly perform it without issues 96-100% of the time. [11, 12, 13]

End result of pelvic vein embolization treatment for pelvic congestion syndrome

Anatomical diagram showing the effect of pelvic vein embolization.

Alternative Treatment Options for Pelvic Congestion Syndrome

If pelvic vein embolization cannot be performed or if another therapy is preferred, patients and doctors can choose between drug, compression, and surgical management. One drug therapy is the use of low-grade painkillers like ibuprofen and naproxen, which may temporarily reduce pain. The other two common drug options are hormone therapies and venoactive agents. These drugs attempt to shrink the enlarged pelvic veins back to normal size and function. [9] Alternatively, patients may choose to wear strong compression shorts that may shrink the enlarged pelvic veins.

For surgical options, doctors may remove the uterus, the ovaries, or both. These surgeries require cutting open the body, which necessitates longer recovery. [4] Pelvic vein ligation is another surgical option. In this procedure, a surgeon ties off the damaged and unneeded pelvic vein. [7]

Comparing Pelvic Congestion Syndrome Treatment Options

Minimally invasive pelvic congestion syndrome treatment

Unlike surgery, pelvic vein embolization does not require any major incisions. This procedures is done by an Interventional & Vascular Specialist using small tubes and wires under the guidance of real-time imaging.

The primary goal of treatment for pelvic congestion syndrome is to relieve pain and discomfort. According to clinical studies, drug and compression therapies reduce pain to some extent in 50-75% of patients, but these are only effective while actively taking or wearing the treatment. [4]

Pelvic vein embolization and surgical treatments reduce pain in more patients and have been shown to provide more pain relief than drugs or compression apparel. [14, 15] These procedures also have a more permanent effect. While uncommon, symptoms can return in some embolization and surgical patients. This recurrence is lower for pelvic vein embolization and can be addressed if needed. [2] Since the pelvic vein embolization procedure is less invasive, the recovery time is also much shorter than that of surgery. [4]

Relief From Pelvic Congestion Syndrome in Dallas, TX

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References
[1] Eklof, B., Perrin, M., Delis, K. T., Rutherford, R. B., & Gloviczki, P. (2009). Updated terminology of chronic venous disorders: The VEIN-TERM transatlantic interdisciplinary consensus document. Journal of Vascular Surgery, 49(2),
[2] Kim, H. S., Malhotra, A. D., Rowe, P. C., Lee, J. M., & Venbrux, A. C. (2006). Embolotherapy for Pelvic Congestion Syndrome: Long-term Results. Journal of Vascular and Interventional Radiology, 17(2), 289–297.
[3] Umeoka, S., Koyama, T., Togashi, K., Kobayashi, H., & Akuta, K. (2004). Vascular Dilatation in the Pelvis: Identification with CT and MR Imaging. RadioGraphics, 24(1), 193–208.
[4] Antignani, P., Lazarashvili, Z., Monedero, J., Ezpeleta, S., … Wikkeling, M. (2019). Diagnosis and treatment of pelvic congestion syndrome: UIP consensus document. International Angiology, 38(4):265-283.
[5] O’Brien, M. T., & Gillespie, D. L. (2015). Diagnosis and treatment of the pelvic congestion syndrome. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 3(1), 96–106.
[6] Phillips, D., Deipolyi, A. R., Hesketh, R. L., Midia, M., & Oklu, R. (2014). Pelvic Congestion Syndrome: Etiology of Pain, Diagnosis, and Clinical Management. Journal of Vascular and Interventional Radiology, 25(5), 725–733.
[7] Kobeissi, S. S., Majdalany, B. S., Majdalany, C. I., Kanaan, C. N., Gilbert, L. N., & Khaja, M. S. (2019). Pelvic Congestion Syndrome. Journal of Radiology Nursing.
[8] Stones, R. W. (2003). Pelvic Vascular Congestion—Half a Century Later. Clinical Obstetrics and Gynecology, 46(4), 831–836.
[9] Keefe, N. A., & Roberts, A. (2018). Pelvic Congestion Syndrome. IR Playbook, 163–169. doi:10.1007/978-3-319-71300-7_13
[10] Karcaaltincaba, M., Karcaaltincaba, D., & Dogra, V. S. (2008). Pelvic Congestion Syndrome. Ultrasound Clinics, 3(3), 415–425.
[11] Mahmoud, O., Vikatmaa, P., Aho, P., Halmesmäki, K., Albäck, A., Rahkola-Soisalo, P., … Venermo, M. (2016). Efficacy of endovascular treatment for pelvic congestion syndrome. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 4(3), 355–370.
[12] Daniels, J. P., Champaneria, R., Shah, L., Gupta, J. K., Birch, J., & Moss, J. G. (2016). Effectiveness of Embolization or Sclerotherapy of Pelvic Veins for Reducing Chronic Pelvic Pain: A Systematic Review. Journal of Vascular and Interventional Radiology, 27(10), 1478–1486.e8.
[13] Hansrani, V., Abbas, A., Bhandari, S., Caress, A.-L., Seif, M., & McCollum, C. N. (2015). Trans-venous occlusion of incompetent pelvic veins for chronic pelvic pain in women: a systematic review. European Journal of Obstetrics & Gynecology and Reproductive Biology, 185, 156–163.
[14] Nasser, F., Cavalcante, R. N., Affonso, B. B., Messina, M. L., Carnevale, F. C., & de Gregorio, M. A. (2014). Safety, efficacy, and prognostic factors in endovascular treatment of pelvic congestion syndrome. International Journal of Gynecology & Obstetrics, 125(1), 65–68.
[15] Laborda, A., Medrano, J., de Blas, I., Urtiaga, I., Carnevale, F. C., & de Gregorio, M. A. (2013). Endovascular Treatment of Pelvic Congestion Syndrome: Visual Analog Scale (VAS) Long-Term Follow-up Clinical Evaluation in 202 Patients. CardioVascular and Interventional Radiology, 36(4), 1006–1014.

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The Materials available on ivcmd.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients.

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Interventional & Vascular Care (IVC) provides minimally invasive image-guided procedures (MIIPs) to patients in the Dallas metroplex. Specializing in venous insufficiency, uterine fibroids, pelvic congestion syndrome, peripheral artery disease, and other conditions.

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