Pelvic Varicose Veins
Varicose veins are swollen blood vessels which do not function efficiently. While they most frequently appear on the legs, they may also develop in the pelvic region, in the lower abdomen or around the genitals, thighs or buttocks.
What Are Pelvic Varicose Veins?
Patients with pelvic varicose veins, or pelvic congestion syndrome, may be asymptomatic. They may also experience troubling symptoms, primarily pain in the region. Women suffer more frequently with pelvic varicose veins, but men are also susceptible to the problem. Pelvic varicose veins may be invisible, particularly when the patient is lying down.
Causes Of Pelvic Varicose Veins
Pelvic varicose veins form when vein walls weaken, known as venous insufficiency, and when valves within the vein deteriorate and allow blood to flow backward, known as venous reflux. Risk factors for pelvic varicose veins include:
- Family history of the disorder
- Repeated pregnancies
- Sedentary lifestyle
Pelvic Congestion Syndrome
Research has shown that as many as a third of all women suffer pelvic pain during their lifetime. When pelvic congestion syndrome is the cause of this pain, the patient may experience it as dull and aching, but may occasionally present as more acute. Such pain tends to be worse at the end of the day and long periods of standing may exacerbate it. Pain may be worse just before a menstrual period or during or after sexual intercourse. Women with this disorder may also experience one or more of the following symptoms:
- Enlarged uterus
- Thicker endometrium
- Ovarian changes
- Stress incontinence
- Back pain
- Vaginal discharge
- Severe menstrual pain or dysmenorrhea
- Abdominal bloating
- Mood swings
Diagnosis Of Pelvic Varicose Veins
There are other causes of pelvic pain than varicose veins in the region. These causes, such as ovarian cancer, must be ruled out before a definitive diagnosis of pelvic congestion syndrome can be made. Since varicose veins in the pelvic region are not always visible even on sophisticated imaging devices, a Doppler ultrasound may be used. The most effective diagnostic test for pelvic varicose veins is usually a CT venogram using contrast dye. The dye is used so that the affected veins can be better visualized on X-ray.
Pelvic Varicose Veins Treatment
If venography makes it clear that varicose veins exist in the pelvic region, we remove them a process called embolization. Embolization, which is a minimally invasive procedure, may be performed one of two ways. The first, the doctor inserts a metal coil into the diseased vein, often either the femoral vein or the ovarian vein, causing a clot to form and blocking blood flow. In the other, we use a sclerosant or a solution which irritates the vein. In either case, the affected vein slowly collapses and other, healthier veins to take over its circulatory role. We perform embolization while the patient is under local anesthesia with intravenous sedation. An interventional radiologist performs this procedure.
Since these veins are deep within the body and cannot be easily reached surgically, embolization is necessary to treat varicose veins in the pelvic region. They are also not available for laser treatment since the heat generated by the laser would put adjacent organs at risk.
Who Is At Risk for Pelvic Varicose Veins?
Women who have been pregnant or are currently pregnant are by far the most at-risk individuals for developing this condition. The veins in the pelvic area expand during pregnancy in order to increase blood flow to the womb. On top of this, the extra weight from the fetus adds additional pressure to the veins in this area. This condition is considered to be very rare for women who have never experienced pregnancy, although not impossible.
A woman who is likely to develop pelvic varicose veins is also at a higher risk for developing varicose veins in their calves. Other factors that put an individual at higher risk include obesity, family history, and more pregnancies.
Risks Of Pelvic Varicose Veins
Although widely considered a very safe and effective form of treatment, ovarian vein embolization does carry some risks. These risks, while rare, may include:
- Blood vessel damage
- Bleeding at the treatment site
- Allergic reaction to the contrast dyes
Pelvic Varicose Veins Recovery
A large majority of patients experience significant pain reduction after the embolization procedure. We may perform this procedure outpatient, but sometimes requires an overnight admission to the hospital for pain management. Once the doctor releases the patient from the hospital, they may spend some days in recovery. We prescribe the patient pain medication for the first few days. After that time, over-the-counter medications should be all that the patient needs. In rare instances, the patient may need to have a second embolization procedure.