Pelvic Congestion Syndrome
Pelvic Congestion Syndrome is a term describing symptoms related to pelvic varicose veins in women. These dilated veins are similar to varicose veins in the legs but occur deep in the pelvis, often due to incompetent valves higher up particularly in the ovarian veins (especially the left). The symptoms vary from a dull aching or dragging sensation which may be worse on standing for long periods or towards the end of the day to more severe discomfort, backache, painful intercourse and painful menstruation. Occasionally there may be associated visible varicose veins on the vulva or associated varicose veins of the thighs and buttocks.
Pelvic Congestion Syndrome (also known as ovarian vein syndrome) is probably a very much under-diagnosed condition and has in the past been a diagnosis made after other conditions have been excluded. It is more common in women who have had multiple pregnancies. Modern non-invasive imaging techniques such as ultrasound, MRI and CT scanning along with an increased awareness of the condition and its clinical features among Gynaecologists means that many more women are now being diagnosed and treated.
Embolisation for Pelvic Congestion Syndrome
Embolisation can be used as a minimally invasive treatment for pelvic congestion syndrome. It will often be necessary to arrange a scan (usually CT or MRI) to confirm the diagnosis and if you have not had a recent clinical examination or are not currently under the care of a Gynaecologist, it is usually sensible to ensure you have seen a Gynaecologist to ensure the diagnosis and have an opportunity to discuss surgical treatments too.
If embolisation is right for you, it is performed as a day case procedure under local anaesthetic and x-ray guidance. A tiny needle puncture is made into a vein in the groin and angiography is performed by injecting dye to show the veins involved and provide a ‘road map’. The underlying problem is reflux (or flow going in the wrong direction) in the veins, possibly related to incompetence of valves. The most common source of reflux is the ovarian vein, expecially, the left. The offending vein is blocked off by placing metallic coils under x-ray guidance and the whole procedure only takes about 30 minutes followed by an hour or two of bed rest afterwards. You can go home later the same day, and back to normal activity virtually immediately. You should notice symptomatic improvement within a few days. Occasionally in more complex cases a two stage or repeat procedure may be necessary.
