Long-term lower abdominal or pelvic pain may have gynecologic, urinary, bowel, nerve or vascular causes.
When to seek emergency care
If any of the following signs occur, call *3003 immediately — do not wait for a routine appointment:
- New sudden severe abdominal pain
- Fever
- Pain with possible pregnancy
- Heavy bleeding
- Near-fainting
What is it?
In some patients, pelvic venous congestion and dilated vessels may be associated with pain. In such cases, interventional radiology is involved in evaluating a vascular cause.
Symptoms
- Persistent lower abdominal pain
- Pain worse during menstruation
- Pain during intercourse
- Worse pain after prolonged standing
- Low back or groin pain
Causes & risk factors
- Endometriosis
- Fibroids
- Inflammatory disease
- Bladder disorders
- Bowel disease
- Pelvic venous insufficiency
Diagnosis
Diagnosis should not rely on one test alone. Symptoms, risk factors, physical examination and investigation results are interpreted together.
- Gynecologic examination
- Ultrasound
- MRI in selected cases
- Blood and urine tests
- Venous imaging when vascular cause is suspected
Treatment approaches
Treatment is individualized according to the severity of the disease, the patient’s overall condition, coexisting diseases and procedural risk.
- Cause-directed therapy
- Gynecologic treatment
- Physiotherapy and pain management
- Pelvic vein embolization in selected cases
- Multidisciplinary follow-up
How we help
The center separately evaluates whether a vascular component may be contributing. If imaging supports pelvic venous reflux, embolization may be discussed.
When a procedure may be needed
Embolization may be considered when pelvic venous dilation and reflux match the pain pattern and other causes have been assessed.
Patient checklist
- Track pain in relation to cycle, posture and activity
- Bring gynecologic reports
- Bring ultrasound/MRI results
- Report possible pregnancy
FAQ
Is chronic pelvic pain always caused by a vascular problem?
No. There are various causes. A vascular cause is considered only when supported by appropriate clinical and imaging findings.
Who is suitable for embolization?
Suitability is determined from the characteristics of the pain, venous imaging and assessment of other causes.
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