OpenHealth Q&A

Understanding Triplicate Renal Veins and Pelvic Congestion Syndrome

A 47-year-old woman, measuring 5'8" and weighing 143 pounds, who is a non-smoker and drinks infrequently, has been prescribed Vyvanse at a daily dosage of 30mg. I chose to discuss the topic of triplicate renal veins due to its uncommon nature. I aim to raise awareness among primary care providers regarding my lengthy battle with pelvic pain, leg discomfort, persistent microscopic hematuria since 2016, profound fatigue, and lumbar pain. While several blood tests and imaging studies yielded mostly normal results—with some indication of moderate lumbar issues—I found myself at urgent care in October 2024 due to abdominal pain. A radiologist interpreting my CT scan suspected pelvic congestion syndrome. Further complications arose during the investigation. A transvaginal ultrasound performed in May 2025 appeared normal, but I managed to convince my gynecologist to refer me to an interventional radiologist. Fortunately, the interventional radiologist carefully examined my imaging results alongside my clinical symptoms and subsequently arranged for an embolization procedure. Upon assessment, significant bilateral congestion was identified, particularly with my left ovarian vein being notably enlarged. Interestingly, I also discovered my anatomy features triplicate renal veins on the right side, with the right ovarian vein draining into the right renal vein rather than the vena cava. This variation isn't classified as abnormal but can definitely contribute to vascular congestion, and it is valuable knowledge nonetheless. The procedure involved placing 17 coils, including one in my left iliac vein to address the reflux and several other smaller branches. Post-embolization, my health has seen marked improvement. My back and leg pains, fatigue, pelvic discomfort, and increased urinary urgency have all significantly reduced. It was only after experiencing relief that I truly understood the extent of my previous condition. Pelvic congestion syndrome may not be as rare as once thought, but its recognition in the medical field is still lacking. I am deeply thankful to the radiologist who interpreted my CT scan and proposed this potential diagnosis, as it offered me a pathway to advocacy for treatment. I want to emphasize the importance of considering pelvic congestion syndrome. While I was able to maintain a functional lifestyle, the underlying misery was undeniable. Following my embolization, I feel revitalized and transformed. In 2022, I underwent an ultrasound for abdominal pain, which noted increased blood flow in the periuterine area, described as "at the very least unusual and should be investigated." However, this suggestion was not pursued at that time. For too long, my symptoms were attributed to anxiety, depression, or perimenopause. I hope that greater awareness of this condition spreads in the medical community, particularly given that a relatively minor procedure can lead to significant improvements in quality of life for many individuals.

Answers (1)

6/29/2025, 11:30:44 PM

OpenHealth AI

Main Points: Recognizing and Advocating for Pelvic Congestion Syndrome (PCS)

It's commendable that you've shared your journey with pelvic congestion syndrome (PCS) and your experience with triplicate renal veins. Your case illustrates the importance of awareness among healthcare providers and the significance of self-advocacy in receiving appropriate diagnosis and treatment.

Explanation: Pelvic congestion syndrome is a condition caused by the dilation of veins in the pelvic region, often leading to chronic pelvic pain and other symptoms. Your history of persistent symptoms like pelvic pain, fatigue, and hematuria highlights how challenging it can be to get a proper diagnosis when various tests appear normal. It’s also quite insightful to note how your unique anatomical variation, such as triplicate renal veins, can contribute to vascular challenges in the pelvic area.

PCS can often be underdiagnosed, as symptoms might be misattributed to other conditions like anxiety or hormonal changes during perimenopause. Your experience after the embolization procedure demonstrates the potential for substantial improvement in quality of life, showing that early recognition and intervention can make a significant difference.

Next Steps:

1. Continue Self-Advocacy: Document your symptoms, treatment responses, and any changes in your condition. This information is invaluable during follow-up appointments.
2. Educate Your Providers: Share your experience and knowledge about PCS with your primary care physician and other healthcare providers. This can help raise awareness and potentially aid others with similar symptoms.
3. Regular Follow-Up: Schedule regular check-ins with your healthcare team to monitor your condition and address any new or returning symptoms promptly.
4. Support Groups: Consider joining support groups or communities for individuals with chronic pain or PCS. Connecting with others can provide emotional support and additional insights into managing your condition.
5. Lifestyle Adjustments: Maintain a balanced lifestyle with a focus on physical activity, stress management techniques (like yoga or mindfulness), and a nutritious diet, as these can help alleviate some symptoms.

Your proactive approach to your health is inspiring, and continued awareness can lead to better recognition and treatment of pelvic congestion syndrome. If you have further questions or need specific advice, feel free to ask.