The Franklin Institute, a science museum in Philadelphia, reports that the average adult body contains approximately 100,000 miles of blood vessels.
Pelvic Congestion Syndrome (PCS) is also known as Pelvic Vein Incompetence (PVI) which manifest as pooling or accumulation of blood in the veins surrounding the pelvis. This chronic medical condition in women is traced to genetics and varicose veins in the lower abdomen. Chronic pain and a constant dull ache aggravated by standing are also associated with this disease.
Speaking with calmness, clarity, and confidence that characterizes his demeanor,Dr. Awais H. Siddique, an endovascular and interventional radiologist, is respected for his proficiency in this science and earned the distinction of being Medical Director at AZH Wound and Vascular Centers in Milwaukee, WI. During his career, he has successfully performed thousands of surgeries for vascular diseases including PCS.
Speaking with calmness and clarity which characterizes his demeanor he explains, “Scientific evidence lags behind real-time developments. However, we know that one of the common prerequisites for PCS is pregnancy or genetics. After their second pregnancy, females begin to feel heaviness, fatigue and see varicose veins in their thighs. These women then develop leaky valves that enable blood to drop, due to gravity, into their pelvis rather than draining back to their heart. Once venous valves become incompetent, more and more blood will pool or collect in the veins. PCS is varicose veins inside your pelvis. Since the veins are not visible on the outside of the body quite often these symptoms are not detected.”
Three major types of blood vessels flowing through the body are arteries, which carry blood away from the heart; capillaries which enable the exchange of water and chemicals between the blood and tissues; and veins which carry blood from the capillaries back toward the heart.
Dr. Siddique explained further, “Consider the fact that the baby grows in the uterus which further obstructs blood flow, especially if the fetus rests on the right side of the mother’s body. The inferior vena cava, one of the largest veins in the body, passes through this area. That’s why pregnant women are told to lay on their left sides when sleeping. The superior vena cava and the inferior vena cava are the two largest veins in your body. The inferior vena cava carries blood from the lower and middle to the heart. The technology used to diagnose PCS is magnetic resonance venography, Ultrasound, and CT scan.”
Women begin to experience symptoms in their 40s and early 50s. Genetics is also a contributing factor for vascular disease. Misdiagnosis of PCS leads to unnecessary hysterectomies to remove all or part of the uterus for many women.
Symptoms include feelings of heaviness and significant pressure in the pelvis, fatigue, pain after sexual intercourse, heavy clear discharge between menstrual cycles and frequent urination. Simple testing will reveal that the patient is suffering from PCS. If a woman is experiencing any of these symptoms, then it is wise to have the appropriate test such as ultrasound with the Valsalva maneuver, cat scan, and venography.
He said, “There are situations and conditions for which a hysterectomy is appropriate. However, many women in their late 40s, early 50s are directed to have a hysterectomy —surgical removal of the uterus— when this will not solve the problem. These are varicose veins surrounding the uterus, enlarging the pelvis, and promoting a leaky vein starting in the left venal/kidney vein. On the right side, it starts in the vena cava.
Treatment “In these cases, I recommend a minimally invasive procedure to embolize or close the vein with tiny fibers of platinum or titanium coils to block the blood vessel that is leaking in the wrong direction.
Many primary physicians are not familiar with Pelvic Congestion Syndrome. Consequently, diagnosis of this disease is still limited.
Endovascular and Interventional Radiologist and Surgeon |Medical Director for AZH Wound and Vascular Center | Milwaukee, WI
“At the age of seven, my family left Pakistan and moved to Dubai for a better life. My father was an executive for Toyota Motor Corporation. I learned everything from him. We had conversations about world events and my career path, starting when I was four years old. I still go to him for advice,” said Dr. Awais H. Siddique.
He honored his father’s encouragement to become a doctor and is an endovascular and interventional radiologist. Using minimally invasive imaging techniques, he diagnoses, treats, and manages conditions in organs, arteries and blood vessels for life-threatening aneurysms to less complex varicose veins.
“After you leave the medical school he said, everything you’ve learned is obsolete in five years. So, one way that I stay abreast of all the innovations in my specialty is by reading the reports and medical periodicals and attending specialty conferences. If you don’t, your practice and patients will suffer.”
He achieved dual certifications thru the American Board of Medical Specialties (ABMS) for the diagnostic radiology and interventional radiology — meaning that he studied beyond the graduation requirements for his specialty, passed exams and peer evaluations to prove his mastery of the extraordinary skills associated with his domain of practice. During his career, he has completed thousands of surgeries for multiple diseases such as cancer, stroke, varicose veins, angioplasty, and biliary tract illness — and been a blessing for countless patients who require his services.
Arriving at his office at 6:45 am, and it’s not uncommon that his day ends at 7:30 pm. “Reflecting on the 65-mile drive home, Dr. Siddique said, “ I don’t mind. It gives me time to decompress and talks with my father and sister in Michigan and brother who lives on the east coast.”
He also exhales by spending time with my family. “My older daughter is a high-level athlete and into horses. The younger one is in high school. I also enjoy kayaking with my wife. Another way that I relax is to drive my Porsche GT3 around the race track. I’m a firm believer in God. My basic philosophy is to live and let live.”
PELVIC the lower part of the torso. It is positioned between the abdomen and the legs. This area provides support for the intestines and also contains the bladder and reproductive organs.
VEINS blood vessels are part of the blood circulation system, and carry blood toward the heart. Most veins carry blood from tissues back to the heart. The pulmonary and umbilical veins carry oxygenated blood to the heart.
ARTERIES any of the muscular walled tubes forming part of the circulation system by which blood is conveyed from the heart to all parts of the body.
Biliary Tract refers to the liver, gallbladder, and bile ducts.
EMBOLIZATION OR EMBOLUS are clotted blood cells that move in the veins or arteries. Blood clots are either a thrombus- obstructing blood flow, or a moving blood clot called a thromboembolus. As an embolus moves through the blood vessels, it likely gets stuck in a passage that it can’t fit through and backs up blood behind it.
The cells that normally get their blood supply via this passage are starved of oxygen (ischemia) and die. This condition is called an embolism. Embolisms occur in various parts of the body such as the lungs or pulmonary; the brain causing ischemic strokes; retinal or small clots that block smaller blood vessels feeding the retina at the back of the eye; and septic which results from an infection in the body that invades the bloodstream and blocks blood vessels.
Most embolisms are the result of smoking, heart disease, high blood pressure, atherosclerosis (buildup of fatty plaque in the blood vessels), and high cholesterol. Many emboli are broken down by the body and go away by themselves; however, may cause death.
Sources: www.health zone, Mosby’s Medical Dictionary, John Hopkins Medical Center