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By Jill Tanner MSN, NP-C and Joseph G. Magnant, MD, FACS, RPVI – Veins Specialists, Fort Myers

THE OTHER CONGESTION THAT IS WORTH TALKING ABOUT  Every year, right around this time, ourselves or someone we know has come down with the common cold.

Although typically short lived the common cold can be a nuisance. It comes with that annoying nasal congestion and that constant search for a tissue. What if I told you that there is another form of congestion, pelvic congestion, which involves the pelvic veins.

Yes, you read it correctly, YOUR PELVIC VEINS. Most people have heard of varicose veins and believe that they can only occur in the legs. Varicose veins occur when the valves within our veins stop working and allow blood to pool in the veins which then causes the veins to become enlarged or “congested”, also known as varicose veins. Varicose veins do not only occur in our legs, but they can also occur in our pelvis which is the root cause of pelvic congestion syndrome.

Pelvic congestion syndrome (PCS) is a subgroup of iliac vein compression syndrome. PCS is most often caused by a narrowed iliac vein which causes collateral veins to develop in the pelvis, bridging one side to the other. Other causes of PCS include pregnancy, central obesity and primary ovarian vein reflux. The symptoms of PCS are related to the increased venous pressure and development of varicose veins in the pelvis.

PCS is a common cause of chronic pelvic
pain. Pelvic pain accounts for up to 40% of gynecological appointments. It typically affects younger women in their childbearing years. Many times women do not have symptoms until they have become pregnant and the symptoms may continue even after pregnancy.

Common symptoms of PCS are the following:
• Large varicose veins from the groin or vulva
• Pain in the pelvis or abdomen especially with
squatting or crouching
• Painful intercourse (during or after)
• Increased pain with menstruation
• Pain in the low back, buttock, or back of the
thighs with prolonged sitting or standing
• Unexplained skin changes or status dermatitis.

The diagnosis of PCS has often been delayed in previous years because the underlying causes were not well understood. We now have a new diagnostic tool to make an accurate diagnosis, intravascular ultrasound (IVUS). If pelvic vein blockages are confirmed to be the cause of the pelvic congestion, IVUS directed stenting of the veins can be performed and the congestion relieved. So if you have been dealing with the symptoms of PCS, maybe you should consider further evaluation and possible treatment.

My name is Mary Anne and I live in the Chicago
land area, where, in most cases we are known for having a high level of health care professionals at our fingertips.  I am 60, physically fit, very active and do not fit the stereotype for someone with Vein problems.  My story is that I had a persistent, extremely itchy rash limited to my lower legs. I saw 5 different dermatologists, who gave me 5
different diagnoses, none of which I believed I had.

I had been scouring the Internet the entire time and I concluded that my problem was either a
rare fungal infection a vein condition called stasis dermatitis. I did suffer from varicose veins in my vaginal area during all five of my pregnancies,
and had a whopper on my thigh, which I had
previously had sclerotherapy on to remove. However I did not have anything more than spider veins currently so I had a hard time convincing myself or anyone else that it might be a deeper Vein problem. I decided it would be easier to rule out the vascular issue, so I made an appointment with the same doctor who did the sclerotherapy. He was highly recommended. I found out that I did indeed have a perforator vein that was
refluxing at the exact area where I had the extremely itchy and weepy rash. The doctor sealed off the leaking Vein with a laser and the itching got better, but both my legs were still more itchy than normal, and would sometimes really flare up. I felt I was using way too much steroid cream, and it was doing a number on my skin.

I went back a number of times to my Vein doctor who had admitted he had only seen a hand full of cases of stasis dermatitis, but he seemed to think he had done everything possible for me. I searched the Internet to find out who the next best doctor was, and found a well renowned doctor who listed stasis dermatitis as one of his specialties. I had to travel an hour away, but was hopeful that I would get an answer. This doctor knew my original doctor, and he took a quick glance and decided he couldn’t help me. I asked him if I might have Vein problems in my pelvis, because of the large vaginal varicosities I had during pregnancy. He said no and I left, utterly dejected.

Around 6 months later, I went to the Internet again. It was now over 2 years of my persistently itchy legs. I decided to find a support group. I found someone posting on a medscape post that seemed to know about this condition. The person referenced a website, so I did a google search and up came Vein Specialists in Ft Myers, Florida. They listed all the problems they treated, and then there was a blurb about the 10-15% of women who failed to get better from traditional vein procedures. They mentioned pelvic issues that could possibly be the cause of these women’s problems. Honestly,  I had spent thousands of dollars by this time. Every dermatologist visit, antibiotics, oral steroids, steroid creams, ablation, sclerotherapy. Why wouldn’t I fly to Florida if it meant an end to my problem?

I came to the offices of Dr. Joseph Magnant in March of 2018 for a thorough Vein evaluation and after a 3 hour ultrasound of both legs and my pelvis, it was found that I most likely had iliac vein compression and that both of my great saphenous veins had severe reflux. No wonder
I was still itchy! It was one of the best decisions I have ever made! A few days later I had a new procedure called IVUS(intravascular ultrasound) which demonstrated a critical blockage in my left iliac Vein related to arterial compression, and I had a stent placed to relive the blockage.

A little more than a month later and my itching is about 70 percent better. I will return at the end of this month, and will have one of my Great saphenous veins sealed. In June I will do the other. It is so good to feel normal again. Another unexpected benefit is that my energy level during long Tennis points is markedly better. I had no idea that that would be the case.  I hope that my story will help all the other women out there who have frustrating symptoms and stories just like me.

You are INVITED to our complimentary seminar to meet our team of providers for an intimate Q&A session.
Monday May 7th 4:30pm
Bonita Springs location
Tuesday May 22nd 4:30pm
Fort Myers location

Limited seating.
Call to reserve your seat and mention code ABC


1500 Royal Palm Square Blvd., Suite 105, Fort Myers, Florida

3359 Woods Edge Circle, Suite 102, Bonita Springs, Florida

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