About Pelvic Congestion Syndrome and Embolization

pelvic-vein-congestions-219x300Pelvic Congestion Syndrome (PCS) is a chronic condition that affects as many as 15% of all women 18 to 50 years of age, and accounts for up to 40% of all gynecology office visits. Pelvic Congestion occurs in women when varicose veins form below the abdomen within the pelvic region. Your pelvic pain is considered chronic if you’ve had it for at least six months.

While there are many causes of chronic pelvic pain, the one our physicians focus on is called pelvic venous insufficiency . This condition is related to problems with the veins and circulation in the ovaries, particularly overly enlarged veins. You might think of it as varicose veins of the ovaries.

The cause of pelvic venous insufficiency is often unknown. It could be related to a physical issue, such as the positioning of the uterus, inflammation, or previous deep vein thrombosis of the pelvis. Hormones are likely also involved, since the condition is more common in premenopausal women. It is also more common in women who have had more than one baby.

Pelvic venous insufficiency often goes undiagnosed. Some physicians may not understand the condition; or they mistakenly think there’s no treatment, so there’s no point in a diagnosis. However, our physicians can provide a treatment that may relieve your pain.

The symptoms often include continual pain and discomfort in your pelvis, like a dull ache, particularly if you’ve been standing for a long time, after sex, before your period, and when pregnant. The pain is usually worse on one side. You may also feel a sense of fullness in your legs and bladder, as well as:

  • Pain in your lower back
  • Bloating
  • Nausea
  • Abdominal cramping

Ovarian vein embolization is the treatment for pelvic venous insufficiency . Following local anesthesia administration, the physician directs a catheter inserted through a small nick in the groin or the neck to the ovarian vein using continuous x-ray imaging. The physician inserts small coils to block some of the blood flow, reducing the pressure in the vein and redirecting the blood to healthier pathways.

Patients are observed in the office 2 to 3 hours after the procedure, and most resume normal daily activities within 48 hours.

Embolization is very effective in the treatment of pelvic venous insufficiency : reports from peer-reviewed literature have shown a success rate of 95% to 100%. In addition, 83% of patients reported significant improvement in their symptoms. It is important to note that although the veins we treat are unlikely to come back, in some cases other pelvic veins may require additional treatment in the future.

Key Questions and Answers about Ovarian Vein Embolization

Chronic pelvic congestion syndrome is a serious condition that affects an estimated 10 million women worldwide and is the second most common cause for ongoing pelvic pain. Many studies have shown that this pain is most likely caused by veins that pool blood in the pelvic region, similar to how varicose veins pool blood in the legs. The most effective treatment for chronic pelvic pain is ovarian vein embolization, often referred to as OVE. A study published in the Journal of Vascular and Interventional Radiology in 2000 established the effectiveness of OVE in reducing or eliminating pain associated with chronic pelvic congestion syndrome. Here are some facts you should know about chronic pelvic pain and OVE procedures.

How is chronic pelvic congestion diagnosed?

Most patients with this condition report painful menstruation and intercourse, lower back and abdominal pain, increased pain and heaviness when sitting or standing and an irritable bladder, or the feeling of having to urinate much more frequently. Some may also have enlarged veins on their buttocks, thighs or vulva. If these symptoms are present, your physician may perform additional tests to determine if chronic pelvic congestion is the source of your pain. A venogram of the pelvic area is considered the gold standard for testing for chronic pelvic congestion conditions, and is an almost painless, minimally invasive procedure done through an IV.

Am I at risk for chronic pelvic congestion?

If you have had hormonal issues related to pregnancy or if you have been pregnant multiple times, you may be at higher risk for this condition. Varicose veins in other places on your body, continuing hormone issues or polycystic ovaries are also factors that may put you at risk for pelvic congestion. Genetic factors play a significant
role as well.

What are my treatment options?

For patients who have been diagnosed with pelvic congestion issues, some medications may provide relief from pain. Certain forms of birth control have proven useful in mild to moderate cases. Surgical procedures are also available that tie off the veins to relieve pressure and pain, although this is much more invasive and has a higher recurrence risk than OVE. For most patients with moderate to severe pelvic congestion, however, OVE procedures offer a safe, non-surgical method to treat this condition effectively on an outpatient basis.

What is OVE?

OVE is minimally invasive and requires an incision of less than 3mm. Your surgeon will insert a catheter with miniaturized instruments that travel through your veins to the site of the problem. Your surgeon will then use extremely small particles or a small device to seal off the offending veins and eliminate the issue at its source. This can provide you with real relief from pain and can ensure that you experience the best possible results from your OVE procedure.


How long is the recovery period?

Most patients can leave the recovery room immediately after the procedure. Cramps are common after OVE and can last for a few days; the first 24 hours are generally the most severe. Depending on your overall state of health, you should be able to return to normal activities and work the following day and should see significant reductions in pelvic congestion pain in as little as three days after OVE.

How effective is OVE?

According to numerous reputable medical studies, at least 90 percent of women who undergo OVE report that their pain is reduced or eliminated after their procedure. Because OVE costs much less than traditional surgery, it can provide a cost-effective alternative for women suffering from chronic pelvic congestion pain.

At NYC Surgical Associates, we provide world-class treatments for a wide range of conditions and offer the most effective solutions for your medical issues. Call us today at 888-286-6600 to set up your initial appointment and to begin your journey to wellness now.

Pelvic Pain Television Segments

The Doctors

CBS News

The Doctor Steve Show