Marketing professionals call it “brand recognition.” It’s consumer recall of a product – athletic shoes, a local coffee shop, or even the Olympics – by its name, logo, or other characteristics.
When medical experts gather for a similar discussion about a health condition, the stakes must be particularly high. In fact, it was the increasing frequency of certain venous conditions, and their lack of diagnosis, that led the American Vein and Lymphatic Society to convene an international, multidisciplinary panel. Their mission? To rebrand the conditions historically known as: May-Thurner syndrome, nutcracker syndrome, and pelvic congestion.
“Those outdated names were actually hindering the diagnosis and treatment of a group of medical conditions.” says Anil Kumar, MD, MRCP, FACC, RPVI, RPhS, Medical Director, the Vein Center at Dignity Health, Yavapai Regional Medical Center (YRMC). “That’s why vascular surgeons, vein specialists and radiologists came together to give them a contemporary, understandable and meaningful name.”
Dr. Kumar and other vein specialists hope the name refresh – pelvic venous disorders (PeVD) – is one patients will feel more compelled to discuss with their respective providers.
The causes and symptoms of PeVD
According to Dr. Kumar, PeVD is caused by varicose veins that develop in the body’s pelvis region and other unusual locations, including, for example, the abdomen (below the navel) as well as the upper thighs and groin area. It’s also a painful condition.
“My patients describe their pain as a diffuse achiness or heaviness in lower back and pelvic area,” Dr. Kumar says. “It’s most noticeable during prolonged standing or periods of inactivity. It is worse at the end of the day. Usually the pain subsides after lying down or elevating the legs and pelvis.”
Other PeVD-related symptoms may include:
- Swelling in one leg but not the other
- Blood in the urine
- Pain, discomfort or itching in the pelvic region
- Frequent urination (tests indicate no infection is present)
- Numbness at the base of the spine (even though an MRI does not show nerve compression or restriction in the back)
- Hemorrhoids
- Irritable bowel syndrome
“Sometimes the only symptom, in addition to pain, is a subtle asymmetry of the legs. This is why we measure patients’ legs at the Vein Center,” explains Dr. Kumar.
PeVD: From Pregnancy through Perimenopause
PeVD often develops during pregnancy, when the body produces additional hormones. Women may find new veins in their lower abdomen, upper groin or buttocks area. These are frequently dismissed as temporary.
“In reality, these women should be referred to a vascular or vein specialist at that time or following their pregnancy,” Dr. Kumar says. “PeVD will often continue to develop gradually in the decades that follow a pregnancy and become more pronounced with menopause.”
This is why PeVD mostly affects postmenopausal women who have had multiple pregnancies. However, women in their 20s – who have not had children – may also experience PeVD. Unfortunately, the condition is frequently undiagnosed, even in patients who have classic symptoms. According to Dr. Kumar, this leads some people to pursue answers from pain experts, urologists, neurologists and psychiatrists.
Diagnosing and Treating PeVD
Diagnosing PeVD at the Vein Center begins with a thorough medical history, examination and an ultrasound study. It also involves education. Patients learn how to manage their PeVD and the associated pain by:
- Lying down and elevating their legs and pelvis
- Learning specific pelvic exercises
- Wearing compression pantyhose
The Vein Center collaborates with a vascular surgeon and interventional radiologists for treatment of advanced PeVD cases.
“PeVD is not simple to diagnose,” Dr. Kumar says. “It can involve many symptoms that when put together add up to a proper diagnosis. That’s the first step to making a big difference in someone’s life.”
And that is something Dr. Kumar hopes will soon be part of the PeVD brand.
For more information about PeVD, talk to your physician or call the Vein Center at YRMC at (928) 759-5890.
Submitted by Dignity Health, Yavapai Regional Medical Center
Dr. Anil Kumar is the Medical Director of the Vein Center at Dignity Health, Yavapai Regional Medical Center.