Pelvic congestion syndrome (PCS) treatment in Jordan

Treatment of uterine and pelvic varices addresses reflux of blood within the ovarian and pelvic veins, a condition known as pelvic congestion syndrome. When the valves in these veins stop working properly, blood pools in them and stretches the vein walls. The typical picture is chronic pelvic pain that builds up through the day, worsens with prolonged standing, before menstruation and after intercourse, and eases when lying down. Some women also notice visible varicose veins over the upper thigh, buttock or vulval area. The most widely used treatment today is percutaneous embolization, performed by an interventional radiologist without open surgery. Under local anaesthetic, a fine catheter is introduced through a vein in the upper thigh or the neck and guided under imaging to the ovarian or pelvic veins. Once reflux is confirmed on venography, the abnormal veins are closed with small metal coils or a sclerosing agent, so blood is redirected through healthy veins and congestion gradually settles. The limits of the procedure matter as much as its benefits. Embolization treats venous reflux only. It does not treat endometriosis, pelvic adhesions, interstitial cystitis or irritable bowel syndrome, all of which are common causes of chronic pelvic pain and must be excluded first. It does not remove fibroids, does not treat polycystic ovaries, and is not a fertility procedure. Improvement is gradual over weeks to months rather than immediate, and some women are left with residual pain that needs continued follow-up. Whether you are a candidate is decided by clinical examination and your doctor's assessment alongside imaging, never by reading an article. Assessment usually starts with pelvic ultrasound and Doppler, may be completed with MR or CT venography, and reflux is confirmed by venography during the session itself. Dilated pelvic veins seen on a scan without troublesome symptoms do not by themselves justify treatment.