What is pelvic venous congestion and what causes it?
Pelvic venous congestion is a condition in which veins that normally surround the uterus and ovaries become stretched, swollen, and tender. These pelvic “varicose veins”, similar to the varicose veins that commonly occur in the legs, can cause severe pressure on the female pelvic organs. The blood in the large veins that drain the ovaries normally flows in an upward direction towards the heart. In the case of varicose veins in the pelvis, the valves in the veins that control the blood flow are not working properly. The blood pools in the veins around the ovaries, the uterus and other pelvic structures, causing pressure and pain.
What are the coils used in the embolization made of?
The coils are made of platinum and are FDA approved.
Will abnormal veins grow back?
Abnormal veins do not grow back. But, abnormal veins can sometimes develop in another area of the pelvis causing a recurrence of symptoms. If needed, the embolization procedure may be repeated to treat this new source of pelvic pain.
How will the blood get drained from the ovaries/pelvis if the veins are blocked?
There are many veins in the pelvis that “take over” the process of returning blood back to the heart. The dilated pelvic veins and pelvic varicosities serve no purpose other than allowing blood to collect and pool, causing pain. Embolizing the dilated pelvic veins/pelvic varicosities relieves pelvic venous congestion and does not interfere with blood return to the heart.
What are the risks and benefits of the procedure?
The risks of the pelvic venogram with ovarian / pelvic vein embolization are as follows:
- Migration of a coil from the ovarian / pelvic vein to the lung. This is an uncommon occurrence and typically the coil can be easily retrieved using a special catheter.
- Non-target embolization with the medical glue used to help block off the congested pelvic / ovarian veins. This means an area other than the congested vein becomes blocked. This is an uncommon occurrence.
- Hematoma or bruising around the site where the puncture was made (in the neck or groin area).
- A reaction to the special dye used during the procedure to help visualize the veins. This is a rare occurrence.
The benefits of the procedure are as follows:
- It is a minimally invasive procedure with a short recovery time.
- 50 – 80 % of all patients have significant reduction of their pelvic pain symptoms.
- Typically, the symptoms do not recur.
- It is an outpatient procedure with a short recovery time.
When can I return to my normal activities or work?
Typically, we recommend taking a week off of work. If you do heavy lifting with your job, we recommend approximately two weeks off of work or returning to work with a restriction on heavy lifting.
When will I feel better?
It takes time for the distended, stretched pelvic veins to shrink and relieve symptoms. It may take up to six months following the procedure to for optimal pain relief to occur. If symptoms do continue after the procedure, they are usually milder than previously experienced.
What if no abnormal veins are found?
Chronic pelvic pain is often the result of several co-existing conditions. If pelvic venous congestion is not identified, then this condition is ruled out as a source for the pelvic pain and other medical conditions will need to be explored.