A 43-year-old female nurse who often runs but suffers from recurring pain in her left lower abdomen seeks medical attention to reveal "Pelvic Depression Syndrome"

A 47-year-old nurse repeatedly suffered from left lower abdominal pain, which was especially aggravated when running, sneezing, and coughing. It seriously affected her life and work. She was sent to the gastroenterology, obstetrics and gynecology, kidney, cardiology and other departments for medical treatment. The exact cause could not be found. Finally, she went to the cardiology department for examination and was diagnosed with "pelvic depression syndrome". After receiving minimally invasive catheter embolization treatment one month ago, the pain improved significantly. She was discharged from the hospital two days after the operation and can now exercise normally.

Chen Qidong, a cardiologist at Taichung Municipal Geriatric Rehabilitation General Hospital, pointed out that pelvic stagnation syndrome occurs in the pelvic cavity just like varicose veins in the legs. The reasons include physical fitness, childbirth, sitting or standing for a long time, and insufficiency of the ovarian vein or pelvic venous valves, resulting in blood reflux, venous dilation and increased pressure, causing pelvic stagnation and chronic pain.

Common symptoms of pelvic depression syndrome include recurring lower abdominal pain, low back pain, and a feeling of heaviness in the pelvic cavity. In some patients, the pain may be more obvious when standing, sitting for a long time, exercising, exerting abdominal force, or before and after menstruation. Because the symptoms are similar to gynecological, gastrointestinal, and urinary system diseases, they are easily ignored.

Chen Qidong said that the nurse surnamed Luo had given birth and also had varicose veins in her lower limbs. After a pelvic vein photography examination, it was found that the left ovarian vein was abnormally dilated, the blood vessels were highly twisted and deformed, combined with pelvic varicose veins and blood reflux, and she was diagnosed with pelvic stagnation syndrome.

The nurse surnamed Luo underwent minimally invasive catheter embolization surgery partially covered by the National Health Insurance, and inserted seven vascular embolization coils to block abnormal venous reflux and reduce blood stasis. Compared with traditional surgery, it does not require large-scale incisions, has the advantages of smaller wounds and shorter recovery period, and provides another treatment option.

However, dilation of pelvic veins does not necessarily mean that patients have this disease, and not every patient needs embolization treatment. Some patients may be complicated by upstream venous return obstruction such as nutcracker syndrome or iliac vein compression syndrome. If embolization is carried out without clarifying the direction of blood flow and the cause, it may affect the original blood return. Judgment must be based on clinical symptoms and imaging examinations.

Chen Qidong reminded that if women repeatedly experience unexplained lower abdominal pain, backache, or pelvic heaviness, especially if it worsens after standing for a long time, moving, or exerting abdominal force, and the cause cannot be found after multi-disciplinary examinations, they can be further evaluated to see if it is related to pelvic vein-related diseases, and symptomatic treatment can be given.