Pelvic pain 11 months after giving birth.

I had my baby 11 months ago and I'm still in pain. I think it's pelvic congestion syndrome. I want to get better but I don't know what to do. What are some steps I can take to improve?

ANSWERS FROM DOCTORS (3)


Answered by Mercy Imaging Centers

First step is to rule in or rule out pelvic congestion syndrome, because there are many alternative disorders that cause pelvic pain.

The key question is: when is the pain at its worst? PCS pain very characteristically occurs after being upright (standing or sitting) for hours and increases with each continuous hour of upright posture. So, it should be at its worst at the end of a day after being upright for many consecutive hours.

Further, PCS pain should improve after laying flat for an hour or so, and NEVER occur first thing in the morning after being flat while sleeping for several hours.

If the pain strikes unrelated to whether you are flat or upright (for example, occurs at night waking you from sleep, or if sometimes getting up and walking around makes it better) then PCS is pretty much off the table. However, if staying up makes it worse and laying down makes it better, then PCS could be present and an imaging study would be the next step to see if you can be treated.

The problem is that standard pelvic imaging exams can miss the diagnosis because they are done flat and the engorged veins can vanish and go undetected. If the history is right, you need a consultation with an interventional Radiologist to make sure the imaging is done properly. The two options are upright transvaginal ultrasound and semiupright catheter venography.

Published on Nov 26, 2016

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Answered by Mercy Imaging Centers

First step is to rule in or rule out pelvic congestion syndrome, because there are many alternative disorders that cause pelvic pain.

The key question is: when is the pain at its worst? PCS pain very characteristically occurs after being upright (standing or sitting) for hours and increases with each continuous hour of upright posture. So, it should be at its worst at the end of a day after being upright for many consecutive hours.

Further, PCS pain should improve after laying flat for an hour or so, and NEVER occur first thing in the morning after being flat while sleeping for several hours.

If the pain strikes unrelated to whether you are flat or upright (for example, occurs at night waking you from sleep, or if sometimes getting up and walking around makes it better) then PCS is pretty much off the table. However, if staying up makes it worse and laying down makes it better, then PCS could be present and an imaging study would be the next step to see if you can be treated.

The problem is that standard pelvic imaging exams can miss the diagnosis because they are done flat and the engorged veins can vanish and go undetected. If the history is right, you need a consultation with an interventional Radiologist to make sure the imaging is done properly. The two options are upright transvaginal ultrasound and semiupright catheter venography.

Published on Jul 11, 2012


Answered by Hratch Karamanoukian, MD, FACS, RVT, RPVI, RPhS

A pelic Doppler ultrasound by an accredited vascular lab is a good way to start. This can be followed by a CT venogram, MRV (MRI variant with venography) and finally tilt table venography (if necessary). The latter is classified as an invasive study.

Published on Nov 21, 2016

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Answered by Hratch Karamanoukian, MD, FACS, RVT, RPVI, RPhS

A pelic Doppler ultrasound by an accredited vascular lab is a good way to start. This can be followed by a CT venogram, MRV (MRI variant with venography) and finally tilt table venography (if necessary). The latter is classified as an invasive study.

Published on Jul 11, 2012


Answered by VeinCare Centers of Tennessee

See your OB for an exam and ask for an evaluation for pelvic congestion syndrome and pelvic varicose veins. This usually will require referral to a vascular surgeon or interventional radiologist experienced in treating PCS.

Stephen F. Daugherty, MD, FACS, RVT, RPhS

Published on Jan 10, 2012

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Answered by VeinCare Centers of Tennessee

See your OB for an exam and ask for an evaluation for pelvic congestion syndrome and pelvic varicose veins. This usually will require referral to a vascular surgeon or interventional radiologist experienced in treating PCS.

Stephen F. Daugherty, MD, FACS, RVT, RPhS

Published on Jul 11, 2012


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