Pelvic congestion syndrome: a rarely recognized cause of chronic pelvic pain-clinical presentation and successful management: a case report

Abstract

Pelvic congestion syndrome (PCS) is an underdiagnosed cause of chronic pelvic pain in women of reproductive age, resulting from venous insufficiency and retrograde blood flow in the ovarian and pelvic veins. The condition typically presents with chronic dull pelvic pain, pressure, and heaviness lasting longer than six months, often exacerbated by menstruation, prolonged standing, and increased intra-abdominal pressure. Due to its nonspecific symptoms and overlap with other gynecological disorders, diagnosis is frequently delayed. Imaging modalities such as transvaginal Doppler ultrasonography, CT venography, and MR venography play a crucial role in diagnosis. We report a rare case of PCS in a multiparous woman with longstanding chronic pelvic pain who had undergone multiple evaluations elsewhere without definitive diagnosis. Timely recognition and appropriate management at our center resulted in significant symptomatic improvement. This case highlights the importance of considering PCS in the differential diagnosis of chronic pelvic pain.