Inquiries Regarding Pelvic Congestion Syndrome
A 47-year-old woman, standing 5'8" and weighing 143 pounds, diagnosed with ADHD and taking 30 mg of Vyvanse daily, reports no additional medications or significant health concerns. She is a non-smoker and consumes alcohol occasionally, typically 1 to 3 drinks per week. Her symptoms consist of intermittent discomfort in the pelvic area, specifically pain on the left side between the ribcage and hip. Prolonged standing intensifies this pain, which feels as if a baseball bat has struck her in the groin. Additionally, she has developed swelling in both groins, beginning with the left side before manifesting on the right. The swelling resembles an inguinal hernia but does not present a palpable mass and diminishes while lying down, causing a sensation akin to being pinched. Furthermore, she has been experiencing long-term microscopic hematuria. In October, a CT scan found the following: 1. An increased presence of periuterine vessels, suggesting potential pelvic congestion syndrome, with an ultrasound recommended to further investigate. 2. One simple hepatic cyst and one cyst on the left kidney. 3. Calcifications present within the right kidney tissue. 4. No signs indicating any acute abnormalities. After visiting an OB-GYN who considered the possibility of PCS and then consulting her primary care physician who deemed it unlikely, she noted that the groin swelling began in January. She returned to her primary care physician to discuss the swelling, leading to an order for an ultrasound. The recent ultrasound results provided the following impressions: 1. Some prominent pelvic and periuterine vessels were observed, though they are nonspecific. 2. There are no indications of an inguinal hernia. Subsequently, the nurse practitioner reached out, stating succinctly that there was no identified reason for the pain, no hernia present, and advised her to discontinue shaving. Does this mean there’s no pelvic congestion syndrome? At this juncture, she feels as though she might be imagining all the pain she has experienced.
Answers (1)
3/26/2025, 11:40:40 PM
OpenHealth AI
It sounds like you're dealing with some challenging symptoms, and it's understandable to feel confused about the potential diagnosis of pelvic congestion syndrome (PCS) given your recent test results. Here’s a concise overview of your situation, followed by some explanations and next steps:
Summary of Main Points
- You have been experiencing pelvic pain, groin swelling, and microscopic hematuria.
- Diagnostic imaging, including CT and ultrasound, shows prominent pelvic vessels but does not confirm PCS or an inguinal hernia.
- Your primary care physician and the nurse practitioner have not identified a cause for your symptoms.
Understanding Your Situation
Pelvic congestion syndrome is characterized by chronic pelvic pain due to dilated pelvic veins. While your imaging indicated increased pelvic vessels, these findings can be nonspecific, meaning they do not definitively diagnose PCS. The absence of a hernia and the remarks from your healthcare providers suggest they currently do not perceive sufficient evidence to conclude you have PCS.
Additionally, it's important to recognize that persistent pain can lead to significant discomfort and distress, and questioning the reality of your symptoms is common when clinical evaluations do not match your experience.
Next Steps
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Consider Symptom Tracking: Keep a detailed log of your symptoms, noting the intensity, duration, and any activities that worsen or relieve your pain. This diary can be useful in future discussions with healthcare providers.
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Explore Pain Management Techniques: Focus on self-care strategies that may alleviate discomfort, such as:
- Applying Heat: A warm compress on the pelvic area can offer some relief.
- Gentle Exercise: Engage in low-impact activities, like walking or yoga, to improve circulation without straining your body.
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Follow-Up with Providers: It may be beneficial to revisit your OB-GYN or primary care physician to discuss your ongoing symptoms and concerns. Make sure to share your symptom diary, which can help them better understand your condition.
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Consider a Specialist Referral: If the pain persists and remains unexplained, asking for a referral to a pain management specialist or a gynecologist with experience in pelvic pain could provide further insights.
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Mental Health Support: Considering the frustration and anxiety stemming from chronic pain without clear answers, consider reaching out for support from a mental health professional specializing in chronic pain management.
These steps can help you manage your symptoms while seeking further clarity about your health. Remember, you are not alone in feeling uncertain about your pain, and sharing your experiences with professionals can lead to a better understanding and relief.
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