Pelvic Varicose Veins

Overview of Pelvic Venous Congestion Syndrome

Varicose veins are usually caused by valve failure within the veins in the legs, but in some people, usually women, the veins with the faulty valves can lie within the pelvis. These faulty valves are also a very common cause of pelvic pain in women (Pelvic Venous Congestion). The valves pump blood up to your heart, if any of the valves fail this would cause the blood to flow in the wrong direction (pelvic venous reflux) and to dilate (varicose veins).

Occasionally, PVC also contributes to varicose veins in the legs, but it is actually quite rare that this is a significant cause that needs treating to control leg varicose veins. If you are told that you require this, please ask us for a second opinion, as it is often advised but unnecessary.

Pelvic Veins Symptoms

The valve failure in pelvic veins causes dilation (swelling) of these veins, which in turn results in the following symptoms:

• A painful/dragging sensation in the lower abdomen/pelvis
• A feeling of fullness in the legs
• Less often, the swelling of the veins causes stress incontinence or irritable bowel syndrome (IBS) through pressure on the bladder or bowel

For women, these symptoms tend to be worse during menstruation periods, after standing for long periods and after sex, and can be accompanied by visible swelling of veins around the vulva. The symptoms are often relieved by lying down.

Pelvic Veins Diagnosis

Pelvic Venous Congestion Treatment

The best treatment is pelvic vein embolisation, which our consultants performed thousands of times over the last 20 years, with great success. Embolisation requires sophisticated X-Ray equipment. As such, you will be treated by one of our consultants at a local private hospital that has the required specialist equipment.

If you suspect that you have a pelvic source of your problems, please let us know prior to making any bookings, and we will call the hospital and request an up-to-date procedure price for you. If you require EVLA treatment, we can undertake this at our Veincentre clinic, in addition to any follow-up procedures. These treatments will be charged in line with our fixed-cost pricing.

The valve failure that causes PVC normally occurs in the veins that drain the ovaries, especially the left ovary. This can be detected by a magnetic resonance scan, but we often recommend, when PVC is suspected clinically by the symptoms and clinical examination, that we proceed straight to what is called a catheter venogram as whilst doing that test the treatment can be carried out at the same time saving both time and money.

The catheter venogram is an X-Ray investigation whereby a thin plastic tube (a catheter) is inserted into a large vein in the groin or neck, and is then guided into the ovarian vein using movie X-Rays. Dye is then injected, and X-Ray images are taken, to show whether the valves in the veins are faulty, and to highlight exactly which veins. The valve failure often affects more than one vein.

Once it is determined that the valves have failed, the same catheter can be used as a conduit through which coils of wire and wool are inserted, thereby blocking and killing off the abnormal veins. Sometimes, glues or sclerosant chemicals are used to achieve the same result.

The procedure is technically demanding on our side, but as a patient, you will hardly feel anything happening. It takes less than an hour to close off all affected veins, and you can get back to normal life after a 30-minute rest and a nice cup of tea.

There has been a lot of media coverage on these conditions and their modern-day treatment, most recently with an award-winning docu-series on PrimeVideo and Netflix called Without a Scalpel. The third episode, “HYSTERical”, concentrates on PVC and follows the stories of three women. (Warning: it is very American!)

A more British description of pelvic venous congestion syndrome is also available on the British Society of Interventional Radiology (BSIR) website. Many of our doctors belong to the BSIR.

Pelvic Vein Treatment Prices

Unfortunately, we cannot quote a fixed price for this treatment, because it requires specialist X-Ray equipment and must be undertaken in a hospital environment. As these hospitals are not Veincentre clinics, we regrettably have no control over what each hospital charges. Different hospitals charge different fees, which can vary widely, but you can expect costs to be between £3,000 and £10,000.