Pelvic Congestion Syndrome Self Assessment Questionnaire

Take this questionnaire if you have heavy or painful menses; or lower abdominal or pelvic pain on a frequent basis; or varicose veins in the legs; or frequent pain during or after sex; or had piles (haemorrhoids) after pregnancy that have persisted; or have had multiple IVF cycles.

Section 1 Basic PCS score

Please click Yes or No as answers.

1. Do you suffer from pain in the legs on being in the standing or sitting position for a while?
Y N
2. Do you suffer from leg swelling on being in the standing or sitting position for a while?
Y N
3. Do you suffer from pain at the buttock and/ or perineal (undercarriage or private areas) region on being in the standing or sitting position for a while?
Y N
4. Do you suffer from regular coital (related to sexual intercourse) pain?
Y N
5. Do you suffer pain during micturition (passing urine) or an urgency to pass urine on a regular basis?
Y N
6. Is the severity of your pain or discomfort get worse closer to your menstrual period?
Y N

If your Basic PCS score is 2 or more; or if you have pelvic pain or discomfort for 6 months or more with any of the symptoms above – move on to questions in Section 2 - PCS Specific score

Your Basic PCS Score is 0

Section 2 PCS Specific score

Please click Yes or No as answers.

1. Do you have varicose veins in the groin or in and around your private areas and vagina now; or have had them during or after pregnancy in the past?
Y N
2. Do you suffer from regular post coital (after sexual intercourse) pain or an ache deep within the private areas and pelvis after sex?
Y N
3. Have you had gynaecological procedures like laparoscopies, hormone treatments and implants or referrals to chronic pain management for a diagnosis of endometriosis over many years but have had no relief from the pain?
Y N
4. Have you had a CT scan or MRI scan that has shown dilated (enlarged) veins in your pelvis?
Y N
Your PCS Specific Score is 0
Adding the two scores gives your Total PCS score 0

What does this score mean for you?

Total PCS Score 0,1 or 2 – The chances that you have PCS (a Pelvic Venous Disorder) is very low – you may wish to consult your Family Physician or Gynaecologist first to assess your symptoms

Total PCS Score 3 to 6 – There is a real possibility that your symptoms may be due to PCS (a Pelvic Venous Disorder) – we at the Venus Clinic will be happy to help assess your symptoms

Total PCS Score 7-14 – There is a very high chance that you are suffering from PCS (a Pelvic Venous Disorder) – you will likely need a full clinical assessment and a PCS Duplex Ultrasound scan to confirm or rule out the diagnosis.

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