This site is targeted at medical and radiology professionals, contains user contributed content, and material that may be confusing to a lay audience. Use of this site implies acceptance of our Terms of Use.

Pelvic congestion syndrome

Pelvic congestion syndrome is a condition that results from congestion of the pelvic veins. It is one of commonly missed and potentially treatable cause of chronic abdominal or pelvic pain. 


It tends to prevail in multiparous, pre-menopausal women who typically present with chronic pelvic pain for more than 6 months 1. The overall population prevalence may approach ~10%.


It is considered the female equivalent to a testicular varicocele.

It is caused by:

  • venous obstruction such as retro aortic left renal vein
  • compression of left renal vein by SMA also known as nutcracker phenomenon, or right iliac vein compression
  • incompetent valves in ovarian vein

Radiographic features

The diagnosis of pelvic congestion syndrome is established by the demonstration of multiple dilated, tortuous parauterine veins with a width greater than 4 mm or an ovarian vein diameter greater than 8 mm 4.

Pelvic ultrasound

May show multiple dilated veins in the adnexae with venous colour flow on colour Doppler.


Contrast enhanced CT typically shows dilated pelvic and ovarian veins.


Treatment options include coil embolisation of the gonadal vein: ovarian vein embolisation.

Updating… Please wait.


Error Unable to process the form. Check for errors and try again.

Alert_accept Thank you for updating your details.