Pelvic Pain

Pain in the pelvis or pain with intercourse (dyspareunia) may result from many conditions involving the intestines, urinary bladder, or the female reproductive organs. A small but significant number of women with chronic or frequently recurring pelvic pain suffer from venous disorders which often remain undiagnosed for years.

 

Symptoms often include worsening pain just prior to or during the menses, prolonged pain after intercourse, enlarged veins around the pubic or labial area and may sometimes be associated with leg pain or swelling with exercise.

Persisting pelvic pain which is not well explained on the basis of other diagnosed pelvic conditions may warrant further evaluation with abdominal/pelvic venous color duplex ultrasound with detailed evaluation of venous flow. This is a very specialized non-invasive study performed by relatively few ultrasound facilities. If a diagnosis of venous obstruction or reflux is made, many patients will experience a dramatic improvement or resolution of symptoms with minimally-invasive treatment.

This venogram is an X-ray showing a contrast material injected into the veins of the left groin. The blood is going through abnormal pathways from the left to the right side of the pelvis to get around an obstruction of the left iliac vein caused by compression by the overlying artery. This problem may cause pelvic pain, pain with intercourse, leg pain, and/or leg swelling. A stent similar to the one shown is placed by a needle stick technique into the iliac vein to open up the obstruction.

Dr. Daugherty has presented information regarding pelvic venous obstruction at a number of major national meetings and teaches on the subject. His report of 2013, published in the Journal of Vascular Surgery: Venous and Lymphatic Disorders in July, 2015, was the first report of a series of such patients published in a peer-reviewed medical journal.

Read more under Conditions (Pelvic/Ovarian Vein Obstruction and Pelvic/Ovarian Vein Reflux/Pelvic Congestion Syndrome) and Treatments (Angioplasty/Stenting and Ovarian/Pelvic Vein Ablation).