Pelvic veins are varicose veins located around the uterus and ovaries. Caused by abnormal pelvic veins, these veins allow blood to pool in the pelvis, rather than being returned to the heart.
Risk factors include multiple pregnancies, previous pelvic surgery and family history.
What are Pelvic varicose veins symptoms?
Pelvic varicose veins do not cause any or only mild symptoms in most women. Called pelvic congestion syndrome (PCS) when symptoms are present, women may report pelvic heaviness and pain. Many have an urge to pass urine frequently and suffer pain during intercourse. All of these symptoms may have persisted for many months. Varicose veins may be visible in some women around their vulva or on their legs.
With symptomatic pelvic varicose veins, women commonly report having seen their family doctors complaining about chronic pelvic pain. A common condition, chronic pelvic pain means many patients have already seen gynaecologists, urologists and gastroenterologists in their search for a diagnosis. Fibroids, endometriosis, chronic pelvic and urinary infections are also common causes of pelvic pain.
How is a diagnosis made?
Diagnosis of varicose veins around the uterus or ovaries can be confirmed by an ultrasound scan or other imaging modalities, such as CT or MR scan.
What are the treatment options?
With a diagnosis of pelvic varicose veins and pelvic congestion syndrome confirmed, various types of treatment are available.
Usually supervised by a gynaecologist, in conjunction with a person’s general practitioner, hormonal treatments may be effective. Hormonal treatments aim to reduce the amount of blood flow within the pelvis by suppressing oestrogen levels.
Surgical treatments include hysterectomy, which may be appropriate in some cases.
Minimally invasive X-ray techniques, such as coiling (embolisation), are also an effective way of reducing the symptoms of pelvic congestion syndrome.
Coiling (embolisation), a minimally invasive X-ray technique, seals the abnormal pelvic veins. Common veins sealed by coils include the left ovarian vein and the internal iliac veins. Pre-treatment ultrasound scans and CT to MR scans identify these abnormal veins, then seal them by coils under X-ray guidance. Typically done under local anaesthetic, coil sealing is a day procedure. Often performed at the same time as coil sealing, sclerotherapy involves introducing a small amount of varicose vein irritant in the varicose veins present in the pelvis.
Overall, treatment of pelvic varicose veins causing pelvic congestion syndrome, with coil sealing and sclerotherapy, can achieve positive improvement in a woman’s pelvic pain symptoms. Many studies report improvement in chronic pelvic pain and other pelvic symptoms following treatment. Vulval varicose veins may also respond well to treatment 1.