Pelvic Congestion Syndrome: Current Diagnosis and Management

Pelvic Congestion Syndrome (PCS) is a common concern for premenopausal, multiparous women with chronic pelvic pain persisting greater than 6 months. It is defined as observable congestion of pelvic veins due to pelvic varicosities that cause reflux and dilation of ovarian veins, resulting in venostasis [1,2]. Although the etiology is unknown, PCS is associated with anterior, posterior or circumaortic location of left renal vein (vascular compression of the left renal vein between the aorta and the superior mesenteric artery) and Nutcracker syndrome. Another marker of PCS includes the absence of functional ovarian venous valves at the junction of left ovarian vein and left renal vein that increase venous pressure in left ovarian vein causing vulvar varicosities [2-4]. It is important to investigate the pathology, as well as the various diagnostic and therapeutic methods available to effectively manage patients with PCS.