Background
There are many causes for pelvic pain in women, but one cause which may be missed is the pelvic vein congestion syndrome. When the ovarian vein valves are weakened, the blood begins to pool in the pelvic veins which become enlarged (varicose veins inside the pelvis).
A wide variety of symptoms may be experienced
- dysmenorrhea (excessive menstrual pain)
- dyspareunia (pain during sex)
- post coital ache
- bladder irritability or stress incontinence
- perineal pain
- bowel trouble
- vulvular, buttock or upper thigh varicosities
- tenderness in the lower abdomen
- backache
- lethargy/depression
- swollen vulva
Most of these symptoms are a direct result of the bulging varicose veins pressing on an adjacent organ, such as the bowel or bladder. The symptoms are made worse by prolonged standing, walking, bending, lifting and sex. The pain tends to increase during the day, and before or during menstruation. Depending on the symptoms experienced, a patient may present to a gynaecologist, vascular surgeon or urologist for consultation.
OVARIAN VEIN EMBOLISATION
Background
Embolisation has proved to be an effective treatment for ovarian vein reflux, also known as pelvic vein congestion syndrome.
Procedure Steps
- Local anaesthetic is administered slowly to the right groin. Some patients require sedation as well.
- A catheter is inserted into the femoral vein at the right groin and advanced to the site of the problem – usually the left ovarian vein.
- Tiny coils, sometimes along with a sclerosing agent are delivered, plugging the faulty left ovarian vein.
- The right ovarian vein and both internal iliac veins are checked that they have competent valves. If further sites of reflux are seen these are also embolised.
After Treatment Care
After ovarian vein embolisation, the patient is asked to lie flat for one hour and then to stay in bed for four hours so that the coils are locked in place by the clotting blood within the isolated vein.
Even following discharge, the patient is asked to reduce activity that evening. They can resume normal activity the next day but are advised to avoid heavy lifting, jogging or work-outs for the following four days.
Because the pelvic veins may take several weeks to reduce in size, the symptoms may not resolve immediately. Backache or an aching feeling in the loins may occur transiently after one week as the veins and clotted blood are absorbed by the body.