Pelvic Venous Congestion (PVCS) Treatment

What are the treatment options for PVCS? Available treatment options for PVCS include pain-relieving progestin hormone drugs, ovarian function-blocking Gonadotropin-releasing hormones, vein embolization, and surgery to remove the uterus and ovaries. Your physician will typically start with medications first to relieve pain. If the medications fail, then they may a more invasive surgical procedure. Vein embolization is the most common type of procedure performed.

Here’s a look at what it involves:

Ovarian and pelvic venous embolization begin as a Vascular Specialist injects sclerosing agents into the varicose veins through a catheter. Next, the doctor attaches small metal plugs or coils to prevent blood flow into the veins. This prevents reflux in the ovarian veins and eases pressure within the engorged veins.

Treating diseases like pelvic and labial varicose veins resolves the backward flow of blood in the ovarian and pelvic veins through embolization. Embolization is an outpatient procedure that provides access to the problematic ovarian veins using a catheter. The procedure is painless and requires no major incisions. The physician will embolize each problematic vein (blocking blood flow) with vascular plugs or coils. Doing so permanently seals off the varicose veins, diverting blood flow to healthy veins. The physician will also deliver sclerosing medication to lower the pressure in the pelvic veins and relieve the pain. Once blood can flow smoothly through healthy veins in the pelvic and labial area, the pain disappears. Patients can usually return to work and light activities the day following the procedure and see a full recovery in about one week. At least 7 in 10 women who undergo the procedure report significant symptomatic relief. This procedure is usually performed by a trained interventional radiologist on an outpatient basis.

Sclerotherapy is a minimally invasive procedure where sclerosing solutions are injected into the veins. It is used to treat spider, reticular and varicose veins. It also blocks the unsightly or non-functioning veins to gradually improve appearance. This generally involves multiple treatments over the course of several months.

Radiofrequency Ablation is a minimally invasive, image-guided procedure used to treat varicose veins. RFA utilizes high-frequency radio waves directed through a catheter to create intense heat within the varicose vein. This closes up the problematic vessel so blood cannot flow through it. Blood flow is then redirected into healthy veins, allowing it to return to the heart. Eliminating the unhealthy vein reduces venous bulging and minimizes leg pain and swelling. It is performed as an outpatient procedure with minimal recovery and slight, but tolerable discomfort.

When Should I Contact My Doctor?

Some women have enlarged veins with no symptoms while others may experience intense aches and pains. In most cases, congested pelvic veins do not warrant a serious cause for concern. Symptoms typically subside as menopause begins. However, if you are experiencing chronic, unbearable pain, our Vascular Specialists offer minimally invasive treatment options to combat painful symptoms.

To get the most out of the consultation, here’s what to do:

  • Know the purpose of the visit and what you want to get from it
  • Before visiting the doctor, put down questions you need them to answer.
  • Bring company along to help ask questions and note down points from the doctor.
  • Write down the name of the diagnosis, its tests, and treatment options explained by the doctor. Also, take notes of any new instructions during each visit.
  • Know the reasons for new medication prescriptions, their benefits, and their risks.
  • Inquire whether it’s possible to treat your condition another way
  • Know why and what the results of a test procedure mean
  • Ask what will happen if you don’t undergo testing or take medication.
  • Ask whether a follow-up appointment is available and note down the visit’s time, date, and reason.
  • Ask the doctor for their contacts in case you need a further chat.

Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure

  • Embolization of the ovarian or pelvic vein has a proven track record of success in providing symptomatic relief for afflicted patients.
  • Embolization helps shut off affected veins. As pressure is alleviated, they will reduce in size.
  • It’s a minimally invasive technique requiring only a tiny incision in the skin and no stitches.
  • There are fewer complications than traditional surgery. Blood loss is minimal, and the incision is not visible. In fact, most patients can go home right after the procedure is completed.
  • 85 % of women who undergo the procedure report significant symptomatic relief within 14 days of the operation.
  • You may be allergic to the iodine-based dye and a contrast agent used to take detailed images.
  • A small number of women develop infections after embolization.
  • Since the procedure involves placing a tube inside blood vessels, it may damage them, cause bruising, or bleeding at the point of incision.
  • If an embolic agent migrates to the wrong place, it may cut off the oxygen supply to the tissue, i.e., non-target embolism.
  • There’s a 10 % chance that the varices may develop in the veins again.
  • It exposes the ovaries to radiation. However, studies have not found any links between the procedure and infertility or abnormal periods.

The doctor will monitor your blood pressure and heart rate. Some patients suffer slight pain or discomfort following the surgery, which can be managed with simple medications taken by mouth or intravenously through the cannula.

Bed rest is advisable for a short period after the procedure. Most patients are cleared to leave the hospital after 4 hours. However, if you’re in significant pain, you might want to stay for longer to receive additional care..

Once discharged, expect to resume your normal activities within a few days. However, driving is not recommended for the first week following the procedure. You may even wait longer in case of groin discomfort.

After your operation or therapy, your doctor may recommend a follow-up scan and checkup. This is to determine whether the operation was successful and address any changes or adverse effects you may have noticed following the treatment. Just like other varicose veins on the leg, engorged veins in the thigh, vulva, buttocks, etc., may need to be treated separately.

The enlarged veins should gradually reduce in size within a few weeks by preventing reflux in pelvic veins. Even the vulvar varicose veins should disappear. You can also seek treatment for any varices in the lower legs. Various safe treatment options can be used to permanently resolve the condition. However, seek treatment for other vein varices only after dealing with pelvic vein varices to reduce the chances of the condition coming back in the future. After treatment, any symptoms you’ve been experiencing due to the vein varices should go away.

  1. You will need to have your warfarin medication altered if you are taking any. Consult with a doctor for details.
  2. Keep a list of your medications, even the herbal ones, and inform your doctor of any allergies, including allergic to the iodine dye.
  3. Inform your doctor of any recent medical issues, illnesses, or if you are pregnant. Pelvic venography and vein embolism involve the use of X-rays; you don’t want the fetus exposed to the radiation.
  4. Pack comfortable clothes; you will also be given a gown at the hospital for use during the procedure.

Treatment Options

Learn more about our treatment options

What to Expect

Learn more about what to expect

Vascular Disease

Return to the interactive body page

Why Monterey Bay Vascular

Congestion of veins in the pelvis and lower abdomen is one of the major causes of pelvic pain. It happens when the vein valves lose functionality, preventing blood from flowing properly. Symptoms include pain when standing, lifting, walking, and during or after intercourse. It’s also characterized by visible varices on the vulva, vagina, inner thigh, and sometimes the buttocks. This condition affects 13-40 percent of women between ages 20 and 45. Symptoms of pelvic venous congestion should reduce after menopause. However, seek medical diagnosis and treatment beforehand will ease pain and improve the appearance of the veins.
Contact our office to speak with an expert in pelvic venous congestion consultation and treatment services at Monterey Bay Vascular.