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Pelvic Venous Congestion Syndrome (PVCS) is a chronic pain disorder caused by dilatation and incompetence of pelvic veins, particularly the ovarian and internal iliac veins, leading to venous reflux and pelvic varicosities.
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It is considered the pelvic counterpart of varicocele in men and is a subset of Pelvic venous disorder (PeVD).
| Mechanism | Explanation |
|---|---|
| Venous reflux/incompetence | In ovarian or internal iliac veins |
| Venous obstruction | May be due to May-Thurner syndrome or Nutcracker syndrome |
| Hormonal factors | Estrogen weakens venous walls, promotes dilatation |
| Mechanical factors | Uterine enlargement, retroverted uterus, or anatomic compression |
Pelvic Venous Anatomy Key Points:
Anatomical asymmetry explains predisposition of left-sided pelvic congestion.
| Symptom | Description |
|---|---|
| ‣ | >6 months, dull, aching; worsens after prolonged standing or intercourse |
| ‣ | Pain during or after intercourse |
| ‣ | May coexist with endometriosis |
| Postural worsening | Symptoms increase with standing, walking, or menstruation |
| Varicose veins | Vulvar, perineal, or lower extremity varicosities |
| Pelvic heaviness or fullness | Common complaint due to venous distention |