Condition Guide · Sheffield Vein Clinic

Pelvic Congestion Syndrome in Sheffield

Chronic pelvic pain that is worse after standing and better lying down may have a venous cause. Pelvic congestion syndrome is frequently missed — but it is diagnosable and treatable. Prof Steve Goode, NHS Consultant Interventional Radiologist, offers specialist assessment and treatment at Sheffield Vein Clinic.

Interventional Radiologist

The specialist best placed to diagnose PCS

Full Venous Assessment

Including pelvic venous anatomy

No GP Referral Needed

Send your enquiry directly to Sheffield Vein Clinic

Minimally Invasive Treatment

Embolisation — no open surgery required

Transparent Pricing

Full cost confirmed before any procedure

Do You Recognise These Symptoms?

Pelvic congestion syndrome (PCS) is estimated to account for up to 30% of cases of chronic pelvic pain in women of reproductive age — yet it remains one of the most underdiagnosed conditions in vascular medicine.

Many women with PCS are investigated extensively for gynaecological, gastrointestinal or musculoskeletal causes before a venous cause is considered. The symptom pattern below is characteristic — and if it sounds familiar, a venous assessment is warranted.

A dull, aching or dragging pain in the pelvis or lower abdomen
Pain that is significantly worse after prolonged standing or sitting
Pain that is worse during or after sexual intercourse (dyspareunia)
Pain that worsens premenstrually and improves during menstruation
Relief when lying down — particularly with hips elevated
Varicose veins on the inner thighs, buttocks or vulva — often the first visible sign
Urinary urgency, frequency or irritable bowel-type symptoms alongside pelvic pain
Low back pain or a dragging sensation in the thighs

Sheffield Vein Clinic on Ecclesall Road serves women across Sheffield, South Yorkshire and North Derbyshire who are seeking a specialist venous assessment for chronic pelvic pain. Prof Goode is a Consultant Interventional Radiologist — the specialty most experienced in diagnosing and treating pelvic venous conditions. No GP referral is required.

What Causes Pelvic Congestion Syndrome?

PCS develops when the veins within the pelvis become varicose — in the same way that varicose veins develop in the legs, but in a location that cannot be seen.

Just as varicose veins in the legs develop when venous valves fail and allow blood to pool, the same process can occur in the ovarian and pelvic veins. When the valves in the ovarian veins fail, blood refluxes back into the pelvis — increasing venous pressure and causing the pelvic veins to dilate and pool with blood.

This venous pooling within the pelvis causes a chronic congestion that produces the characteristic dragging, positional pelvic pain of PCS. Because the affected veins are internal, the condition does not produce the visible bulging veins associated with leg varicose veins — though vulvar or inner thigh varicose veins can be an important clue when present.

Factors that increase the risk of PCS:

Multiple pregnancies — the most significant risk factor for ovarian vein incompetence
Female sex hormones — oestrogen causes vein wall dilation and valve weakening
Polycystic ovarian syndrome — associated with increased pelvic venous volume
Retrograde flow anatomy — anatomical variants that predispose to pelvic reflux
Family history of varicose veins or venous disease

A Real Diagnosis

Pelvic congestion syndrome was historically dismissed and sometimes attributed to psychological causes. It is a recognised medical condition with a clear anatomical basis — and advances in imaging and greater specialist awareness have led to significantly improved diagnosis and treatment outcomes in recent years.

How Is Pelvic Congestion Syndrome Diagnosed?

PCS is a diagnosis made through imaging — and Interventional Radiology is the specialty most experienced in obtaining and interpreting that imaging.

Duplex ultrasound of the pelvic veins is typically the first-line investigation — assessing for dilated ovarian veins, reversed flow on Valsalva manoeuvre, and pelvic venous congestion. Where duplex findings are equivocal, cross-sectional imaging (CT or MR venography) provides more detailed anatomical information.

The gold standard for definitive diagnosis — and simultaneous treatment — is catheter-based venography, performed by an Interventional Radiologist. A catheter is advanced into the pelvic and ovarian veins under X-ray guidance, allowing direct visualisation of the venous anatomy and reflux pattern.

Prof Steve Goode is a Consultant Interventional Radiologist with expertise in pelvic venous conditions. At your initial consultation at Sheffield Vein Clinic, he will assess your symptoms, review any previous imaging and determine the most appropriate diagnostic pathway.

Why Pelvic Congestion Syndrome Matters

PCS is not a minor inconvenience — for many women it is a significant cause of chronic pain, reduced quality of life and reproductive health impact that goes unaddressed for years.

QUALITY OF LIFE

Chronic Pain & Its Impact

Persistent pelvic pain disrupts work, relationships, physical activity and sleep. Many women adapt their lives around their symptoms — avoiding prolonged standing, exercise or intimacy — without realising an effective treatment exists.

DIAGNOSTIC DELAY

Years Without a Diagnosis

The average time from symptom onset to diagnosis of PCS can be measured in years. Multiple normal gynaecological investigations — laparoscopy, ultrasound, MRI — do not rule out a venous cause. A venous specialist assessment is a different pathway.

VISIBLE VARICOSE VEINS

Pelvic Varices & Leg Involvement

In some patients, pelvic venous reflux escapes into the legs — causing varicose veins on the inner thighs or vulva that recur after standard treatment. Identifying the pelvic origin is essential for lasting results in these cases.

If you have been investigated for chronic pelvic pain without a clear diagnosis, a venous assessment with Prof Goode is a meaningful next step — not a last resort.

Treatment Options for Pelvic Congestion Syndrome

The most effective treatment for PCS is ovarian vein embolisation — a minimally invasive catheter-based procedure performed by an Interventional Radiologist.

Ovarian vein embolisation is performed as a day case procedure. A catheter is advanced through a small puncture in the neck or groin into the dilated pelvic and ovarian veins, which are then sealed using coils or sclerosant agents. No general anaesthetic. No surgical incision. Most patients return to normal activities within a few days. Clinical studies report significant improvement in pelvic pain in the majority of patients following embolisation.

Prof Goode is a Consultant Interventional Radiologist experienced in endovascular management of pelvic venous disease. Please contact the clinic to discuss your symptoms and arrange an appropriate assessment. Treatment availability and approach will be confirmed at consultation — see our pricing page or contact us directly.

Why See Prof Steve Goode for Pelvic Congestion Syndrome in Sheffield?

NHS Consultant Interventional Radiologist. Newly appointed Professor. The specialist who sees — and treats — every patient personally.

Prof Steve Goode is a Consultant Interventional Radiologist at Sheffield Teaching Hospitals NHS Trust and newly appointed Professor — bringing NHS subspecialty expertise in image-guided vascular procedures to Sheffield Vein Clinic on Ecclesall Road.

Interventional Radiology pioneered the minimally invasive, ultrasound-guided techniques now used as the gold standard in vascular medicine. Prof Goode is research-active — his clinical practice is informed by current evidence, not historical protocols.

Sheffield Vein Clinic serves patients across Sheffield, Rotherham, Barnsley, Chesterfield, Doncaster and across South Yorkshire. No GP referral required.

Duplex ultrasound performed personally by Prof Goode at every first consultation
Assessed and treated personally — not passed to a junior clinician
NHS Consultant and Professor — research-active, evidence-based care
Full range of vein treatments available at Sheffield Vein Clinic
Continuity of care — the same consultant throughout your treatment
Transparent pricing — full cost confirmed before you proceed

Frequently Asked Questions

Answers to the questions patients across Sheffield and South Yorkshire ask most often.

Is pelvic congestion syndrome a real diagnosis?

Yes — PCS is a recognised medical condition with a clear anatomical basis, caused by incompetent pelvic veins and associated venous hypertension. It was historically underdiagnosed and sometimes dismissed, but advances in imaging and greater specialist awareness have led to significantly improved recognition and treatment in recent years.

Who is most likely to develop pelvic congestion syndrome?

PCS most commonly affects women between the ages of 20 and 45, particularly those who have had more than one pregnancy. Pregnancy causes significant dilation of the pelvic veins, and the valves may not recover their function fully after delivery. Hormonal factors also play a role, and the condition typically improves after the menopause.

Can I have PCS if I have no visible varicose veins?

Yes — pelvic varicose veins are internal and may not be visible on the surface at all. Vulvar or upper thigh varicose veins, when present, can be an important clue, but many women with PCS have no external varicose veins whatsoever. The diagnosis is made through internal imaging, not external examination.

Does pelvic congestion syndrome affect fertility?

PCS itself does not typically impair fertility. Treatment with ovarian vein embolisation is generally not contraindicated in women who wish to conceive in the future, but this will be discussed in detail at your individual consultation with Prof Goode.

Do I need a gynaecological investigation before seeing Prof Goode?

No — you can request a consultation at Sheffield Vein Clinic directly, without prior gynaecological investigation. However, if you have already had investigations including ultrasound, MRI, laparoscopy or blood tests, please bring these to your appointment as they will help inform the assessment.

What is the recovery like after ovarian vein embolisation?

Most patients are discharged the same day. There is typically some pelvic cramping and mild discomfort for one to three days, managed with standard analgesia. Return to normal daily activities usually occurs within a few days, and to more strenuous activity within one to two weeks. Clinical improvement in pelvic pain typically develops over six to twelve weeks as the venous pressure normalises.

Find Out Whether PCS Is Behind Your Symptoms

If you have experienced unexplained chronic pelvic pain — particularly pain that is worse after standing and better lying down — a venous assessment with Prof Steve Goode could provide answers that other investigations have not.

Sheffield Vein Clinic · 772–774 Ecclesall Road · Sheffield · South Yorkshire. No referral required.

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