Pelvic Congestion Syndrome

(PCS)

Varicose Veins
and Laser Treatment

Patrik J Tosenovsky

Patrik J Tosenovsky

MD, PhD, Vascular Specialist

MD, PhD, Vascular Specialist

What is PCS or Pelvic Congestion Syndrome?

Endovenous thermal ablation is a minimally invasive percutaneous

procedure performed in the office setting. Patients complain of less
pain and discomfort and return to work earlier then after open surgery.

It is a pelvic pressure or pain or lower back pain or ache. The pain gets worse
throughout the day, with standing, and sometimes with sexual intercourse. Some
women may have varicose veins in the perineum, vulvar varicosities or haemorrhoids.

Typical presentation of female patient is:

s pelvic pain/ache lasting for more then 6 months
s the pain maybe worsened by standing, prolonged
sitting and at the end of the day, pain before onset
of menses, during or after intercourse
s urinary frequency (bladder urgency)
s varicosities of perineum, vulva, buttocks and/or legs
s dysmenorrhea, discharge, cervical motion or ovarian
tenderness

How is PCS treated?

Treatment is usually a combination of sclerotherapy and endovascular coiling on
out-patient basis which will not require any surgical cut but rather through the
needle procedure.
Suite 31, Hollywood Specialist Centre
95 Monash Ave, Nedlands WA

Tel: 08 9389 1533

Fax: 08 9389 1486

Consulting also at:

3*/'-URDOCHs-EAD-EDICAL+ALAMUNDA
soon in Midland and Subiaco
www.avascular.com.au
www.facebook.com/patrikjtosenovsky

The care of patients with varicose veins and

associated chronic venous diseases: clinical
practice guidelines of the Society for Vascular
Surgery and the American Venous Forum.
Gloviczki P et al. J Vasc Surg.2011 May;
53(5 Suppl):2S-48S
s Most patients end up with absolutely no surgical cut
s Although it is a local anaesthetic procedure we
have consultant anaesthetist present giving twilight
anaesthesia for greater comfort
s Recovery is literary few hours for most patients
s Good quality ultrasound is only imaging needed for uncomplicated veins
s Patients are always given all medically sound options to choose from
Suite 31, Hollywood Specialist Centre
95 Monash Ave, Nedlands WA

Tel: 08 9389 1533

Fax: 08 9389 1486

Consulting also at:

3*/'-URDOCHs-EAD-EDICAL+ALAMUNDA
soon in Midland and Subiaco
www.avascular.com.au
www.facebook.com/patrikjtosenovsky

Acute Deep Vein Thrombosis

(acute DVT)

Chronic Deep Vein Thrombosis

(DVT)

Patrik J Tosenovsky

Patrik J Tosenovsky

MD, PhD, Vascular Specialist

MD, PhD, Vascular Specialist

Acute DVT can affect any deep vein of the lower or upper limbs and in many cases
can be treated by anticoagulation alone. In case of iliofemoral DVT however the
conservative management is not adequate and can cause
postthrombotic syndrome.

Chronic DVT in many cases causes limb swelling, chronic ache or pain in the leg,
thigh or pelvis when walking, pigmentation of the leg and ulcers. These symptoms
and signs are collectively called Post-thrombotic syndrome.

Within 2-4 week from the first symptoms onset the acute DVT can
be successfully treated by pharmacomechanical thrombolysis
which was shown to be very effective.

Images of iliac
veins compressed
Non healing venous ulcer

Almost completely healed ulcer after

venous angioplasty and stenting

Appropriate treatment can change patients quality of life dramatically. Out patient
surgery improves circulation in the venous system so the swelling decreases,
patients can walk with no pain and ulcers heal.
Suite 31, Hollywood Specialist Centre
95 Monash Ave, Nedlands WA

Tel: 08 9389 1533

Fax: 08 9389 1486

Consulting also at:

3*/'-URDOCHs-EAD-EDICAL+ALAMUNDA
soon in Midland and Subiaco
www.avascular.com.au
www.facebook.com/patrikjtosenovsky

Suite 31, Hollywood Specialist Centre

95 Monash Ave, Nedlands WA

Tel: 08 9389 1533

Fax: 08 9389 1486

Consulting also at:

3*/'-URDOCHs-EAD-EDICAL+ALAMUNDA
soon in Midland and Subiaco
www.avascular.com.au
www.facebook.com/patrikjtosenovsky