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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).

Epidemiology


Etiopathogenesis


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.

Clinical features


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

Radiology