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The Pain After Pregnancy: Pelvic Congestion Syndrome

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Many women experience a painful condition known as pelvic congestion syndrome as a side effect of pregnancy. This condition - and a medical treatment known as coil embolization - recently made the news when featured in the UK's Daily Mail. Tiny coils inserted into the neck are proving to be an effective treatment for women with pelvic congestion syndrome. These coils seal off damaged veins to improve circulation, reduce pain and lower the risk of life-threatening complications of varicose veins in the ovaries.

What is Pelvic Congestion? 

Pelvic congestion is a painful condition caused by varicose veins in the ovaries. According to Stanford Health Care, a division of Stanford University, pelvic congestion happens as a side effect of pregnancy in about 15 percent of women. The risk of developing pelvic congestion syndrome increases with each subsequent pregnancy, and women pregnant with multiples, like twins, have a higher risk of developing the condition.

During pregnancy, blood vessels expand to accommodate increased blood flow. This expansion can cause the valves of the veins responsible for keeping blood flowing in the right direction to malfunction. When these valves malfunction, blood begins to pool and back up into the veins.

When blood backs up into the veins, the affected vein becomes varicose, or swollen and painful.

The primary symptom of pelvic congestion is pain in the pelvis or lower abdomen. This pain may be a chronic dull ache, a sharp, stabbing pain or cramps. Pain usually improves after rest but can increase after periods of activity or exercise.

Some patients with pelvic congestion also experience pain during intercourse and during menstruation.

Urination and bowel movements can also be extremely painful for patients with pelvic congestion.

Treating Pelvic Congestion 

Treatments for pelvic congestion involve hormone therapy to reduce the size of the affected veins, and embolization, a procedure in which the vein is plugged. During coil embolization, a small incision is made in a vein in the patient’s neck, and a catheter is guided through the vein to the affected area. Tiny coils are placed through the catheter inside the vein to seal off the damaged area. Blood is then rerouted to healthy blood vessels.

Patients who undergo coil embolization experience a reduction in symptoms and improvement over six weeks after the procedure.

Beyond Pelvic Congestion: The Warning Signs of Varicose Veins

Pregnant women are also at risk of developing varicose veins in the legs. Unlike varicose veins that cause pelvic congestion, varicose veins in the legs can be seen. Affected veins are swollen and gnarled, bluish to dark purple and very painful.

Some patients with varicose veins experience burning or severe cramping in the legs, itchiness, and discoloration of the skin of the afflicted area. These symptoms indicate a more serious circulation issue and warrant an examination by a physician.

Treatments for Varicose Veins

Self-care treatments can help treat varicose veins, like exercising and elevating the legs to improve blood flow. Some patients also wear compression stockings to keep blood flow moving in the right direction and to reduce swelling.

Other treatments for varicose veins include minimally invasive procedures to destroy damaged veins.

"Minimally invasive procedures are popular treatments for varicose veins because they quickly give patients relief from painful symptoms," said Dr. Michael Budler, M.D.

Budler is an interventional radiologist in Grand Island, Nebraska, who treats varicose vein patients using laser ablation. During the laser ablation procedure, Budler makes a small incision in the affected area and inserts a tiny laser fiber into the vein. The heat of the laser seals off the damaged vein and blood flow is rerouted through other healthy veins.

The procedure takes only about 30 minutes, and there is no downtime required after the procedure. Patients should avoid strenuous activity for two weeks after their ablation procedure.

Other minimally invasive treatments for varicose veins include microphlebectomy, in which the damaged veins are physically removed from the leg through small incisions, and sclerotherapy, a procedure in which the veins are injected with a chemical solution that causes the affected vein to collapse.

Like laser ablation, microphlebectomy and sclerotherapy both have no post-procedure downtime requirements and also reduce painful symptoms and improve circulation quickly.

 

Sources:

Daily Mail. "Tiny coils that go into your neck help alleviate the pain of pelvic varicose veins." Daily Mail. 2 May 2017.

Stanford Health Care. "Pelvic Congestion Syndrome". Stanford Health Care. 2017.

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