Last year I had surgery for Nutcracker Syndrome, and later had my left ovarian vein coiled due to symptoms of pelvic congestion. Now, I am experiencing identical pain/discomfort, but my new gynecologist says I am too old to have pelvic congestion syndrome. I am on HRT with hormone pellets containing testosterone and estradiol. I've had 2 pregnancies, and my uterus and ovaries have been removed. Do you concur?
The best person to get information from is another gynecologist.
Published on Jul 11, 2012
Yes, it sure is. It is less likely but certainly possible.
Published on Jul 11, 2012
You may have right ovarian vein reflux now causing your symptoms of pelvic congestion syndrome.
Published on Jul 11, 2012
Of course its possible.
Published on Jul 11, 2012
The short answer is: if you're symptomatic, you need to be re-evaluated.
Published on Jul 11, 2012
If you were diagnosed with it at age 65, why are you excluded from that diagnosis at age 66? It does not make sense that they would say that unless the initial diagnosis was incorrect ... but that is highly doubtful because both have specific diagnostic criteria.
Pelvic congestion syndrome is defined as chronic pelvic pain with perineal or vulvar varicosities from reflux or obstruction of the gonadal, gluteal or periuterine veins.
Patients with pelvic congestion syndrome (PCS) are typically in the 2nd and 3rd decades of life, are multiparous (have had many completed pregnancies), primarily premenopausal. Having a positive family history for pelvic congestion syndrome is a risk factor.
Venography remains the gold standard in the diagnosis of pelvic congestion syndrome. However, its usefulness has been supplanted by Duplex ultrasound, CT scanning to exclude pelvic pathology and magnetic resonance venography (MRV). Any or all of these can be repeated to confirm your diagnosis.
The coils can be recanalized in your case and in such a possibility, repeat diagnostic studies are important. In the nutcracker syndrome, left renal vein compression suspected at computed tomography or magnetic resonance is confirmed following venographic demonstration of a pressure gradient of exceeding 3 mmHg.
You should have the studies repeated by another GYN if your symptoms have recurred AND if you felt better after initial treatment.
Published on Jul 11, 2012