Chronic Pelvic Pain: Hope for a Solution

Guest blog by the Society of Interventional Radiology.

One in six women in the United States suffers from chronic pelvic pain. Yet many experience delays in diagnosis and treatment, receive improper treatment for the condition, or no care at all. These women will often cycle through a variety of physicians over a prolonged period because there are many differing causes of pelvic pain, which are often difficult to diagnose. Sadly, many women give up seeking treatment because providers cannot give them answers, or worse – dismiss their pain and decide to just live with it. Chronic pelvic pain arises from a variety of causes, including pelvic venous disorders (PeVD), which is also known as pelvic congestion syndrome. Fortunately, researchers and clinicians are finally bringing this particular condition to light through interventional radiology.

In in the United States suffers from chronic pelvic pain. Yet many experience delays in diagnosis and treatment, receive improper treatment for the condition, or no care at all. These women will often cycle through a variety of physicians over a prolonged period because there are many differing causes of pelvic pain, which are often difficult to diagnose. Sadly, many women give up seeking treatment because providers cannot give them answers, or worse – dismiss their pain and decide to just live with it. Chronic pelvic pain arises from a variety of causes, including pelvic venous disorders (PeVD), which is also known as pelvic congestion syndrome. Fortunately, researchers and clinicians are finally bringing this particular condition to light through interventional radiology.

PeVD and Interventional Radiology

PeVD is an often misdiagnosed, but treatable, condition causing chronic pelvic pain that occurs when enlarged veins develop in the pelvis including the uterus or ovaries. These enlarged veins are not only internal but can be external involving the genitals and thighs. Patients with PeVD endure sometimes severe pain in the pelvic area. These disorders usually affect women who have previously been pregnant and have experienced a backup of blood flow to the ovarian and pelvic veins, similar to varicose veins in the legs. The condition presents with a wide variety of interrelated symptoms, making it difficult for most providers to accurately diagnosis and treat. The pain is usually worse at the end of the day, during periods or after sexual intercourse, and is characterized by heaviness and cramping.

However, PeVD can be readily identified and treated with the help of interventional radiologists or IRs. IRs are board-certified physicians who use imaging guidance to deliver minimally invasive, targeted treatments with a quicker recovery time than traditional surgery. To diagnosis PeVD, an IR will see patients in clinic to evaluate symptoms and use ultrasound, CT scans, or MRIs to evaluate patients for enlarged veins that could be the cause of their chronic pelvic pain.

How to Treat PeVD

Because PeVD can be challenging to evaluate and treat, and may overlap with other diagnoses, the optimal approach is multidisciplinary, bringing together a team of specialists to provide targeted care for each patient’s needs. This kind of integrated care team may include interventional radiologists, gynecologists, urologists, gastroenterologists, mental health professionals, physical therapists, and other specialists, depending on a patient’s specific symptoms or conditions.

If an IR determines a vascular cause exists for the pelvic pain, they can perform a minimally invasive treatment known as embolization, a procedure that uses tiny particles to block off the enlarged veins. This outpatient treatment has been proven safe, effective, and long-lasting and preserves the uterus, allowing patients to quickly return to normal activities.

Bringing PeVD to Light

Unfortunately, many women are unaware of this treatment option, and many practitioners are not fully familiar with its benefits. The Society of Interventional Radiology is focusing its effort on establishing the diagnostic criteria and research base that will help physicians identify PeVD. While chronic pelvic pain can be mild for some, it can also drastically affect a woman’s quality of life. Women deserve to get clear answers and treatment for their pain. So, it’s important that physicians and their patients understand this is a condition that can be effectively treated.

If you are experiencing symptoms such as pain or heaviness in the pelvic area and enlarged veins on your genitals or thighs, ask your doctor whether they could be related to PeVD and whether an IR might be able to help with diagnosis. Speak with your doctor, and work to create the treatment plan that’s best for you.

For more information, visit sirweb.org/patients.