Pelvic Pain Treatment From a Vascular Surgeon

Chronic pelvic pain makes everyday life difficult, but there are treatments available. A vascular surgeon can help you find a pelvic pain treatment that suits your needs. This article will explore the causes of pelvic pain and vascular treatments for when it becomes chronic.

What causes pelvic pain?

Pelvic pain is any dull, sharp, intermittent, or persistent pain in the pelvis and the lower abdomen. An issue with the pelvic veins or floor, urinary tract, digestive system, or reproductive system typically gives rise to this pain. As a result, some patients have accompanying back, thigh, or buttock pain. If pelvic pain lasts at least six months, it is considered chronic.

Reproductive causes

Most often, pelvic pain can be traced back to the female reproductive system. Such causes include endometriosis, ovarian cysts, fibroids, miscarriages, and ectopic pregnancies. An OB-GYN can provide additional treatment for these issues.

Vascular causes

However, pelvic pain unrelated to the reproductive system could be pelvic congestion syndrome (PCS). PCS is a condition in which there is an issue with blood circulation in the ovaries and pelvis, either due to pregnancy or a decrease in estrogen levels. When the veins are too dilated (such as with PCS), blood can flow backward through them (reflux), pooling within the vein and straining it. In these cases, pelvic pain treatment will focus on improving circulation within the pelvis, eliminating pooled blood, and untwisting and narrowing pelvic veins.

Diagnosing vascular causes

If pelvic pain becomes chronic (lasts more than six months) and an OB-GYN has ruled out gynecological causes, consult a vascular surgeon. They will conduct tests to determine the cause of the problem and, if applicable, diagnose PCS. Often, this involves a pelvic exam along with one of the following diagnostic scans or tests:

• Pelvic venography: The standard diagnostic tool for PCS utilizes a catheter and X-rays to locate dilated veins and areas where blood has pooled within them.
• Ultrasound: A non-invasive diagnostic test medical teams use to detect vein dilation and reflux.
• MRI or CT scans: More detailed than an ultrasound, MRIs and CT scans can also reveal vein dilation, reflux, and irregular growths.
• Laparoscopy: A surgical test used to examine the dilation of the pelvic veins.

Although pelvic venography is the standard diagnostic tool, most vascular doctors will order an ultrasound first because it is less invasive.

Vascular treatments for pelvic pain

If the cause of pelvic pain is determined to be vascular, the patient may benefit from many treatment options. For example, compression garments can help improve blood flow within the pelvis. If the issue is an increase in estrogen, medications such as medroxyprogesterone acetate may help. Other common pelvic pain treatments for PCS include:

• Laparoscopy: While this can diagnose PCS, laparoscopy can also be a treatment. The vascular surgeon will tie the problem veins to prevent further complications.
• Ovarian vein embolization: Also known as sclerotherapy, this is a procedure in which the vascular surgeon blocks reflux to reduce blood pooling.
• Bilateral salpingo-oophorectomy: The most comprehensive pelvic pain treatment option, the vascular surgeon removes the uterus, ovaries, and fallopian tubes to complete this procedure.

Learn more about pelvic pain treatment

Have you developed chronic pelvic pain? A vascular doctor can help determine whether PCS is the cause and find the correct treatment to bring you relief. Call our office today to learn more.

Request an appointment here: https://visoc.org or call Vascular & Interventional Specialists of Orange County at (714) 598-1194 for an appointment in our Orange office.

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