What is Pelvic Congestion Syndrome?
Pelvic Congestion Syndrome, also known as ovarian vein reflux, is a medical condition in which chronic pelvic pain occurs secondary to abnormal swelling of the veins (varicose veins) in the pelvis. Strongly linked to increasing age and prior pregnancy, this condition is due to abnormal leaky valves in the veins of the pelvis. This causes an increase in pressure in the pelvic veins which causes pain. It can also be associated with varicose veins in the thigh, buttocks and labia. In fact, PCS is similar in causes, symptoms and management to typical varicose veins in the legs.
Ovarian Vein Embolisation to Treat PCS
Ovarian vein embolisation is a procedure used to reduce blood flow to the varicose veins in the pelvis.
How is the procedure done?
The procedure is completed by an interventional radiologist, who will:
- Make a small incision in your arm or groin, and insert a 2-3mm catheter into a blood vessel.
- The catheter is guided to the affected blood vessel using imaging guidance such as x-rays.
- A synthetic material, usually glue or coils (small metal spirals) is used to block the veins supplying the enlarged veins. This can be done as a permanent or temporary solution. This causes the blood to be diverted away from the area and reduce the symptoms of PCS.
- Temporary blocking agents give the body a chance to heal on its own. Permanent embolic agents physically plug the blood vessel and cause scar tissue to form. Permanent agents are used for certain conditions where symptoms are likely to return once a temporary agent dissolves.
How long does the procedure take?
The procedure takes about an hour, and will require a short stay in hospital until sedation has worn off. At Northern Beaches Interventional Radiology, we book almost all our patients in for morning procedures, meaning you’ll be home by the evening.
What is recovery like?
You will have to avoid exercise, heavy lifting, etc for 2-3 days, this includes avoiding intercourse. You may feel tired for a few days. You will almost certainly be able to return to work within a few days.
During your recovery, it’s important to remain hydrated. You may feel some mild discomfort in the pelvis for about a week, and the following menstrual cycle may also cause mild pain.
What are the Benefits and Risks of Ovarian Vein Embolisation?
- Embolisation is highly effective for controlling bleeding
- It is highly successful for reducing symptoms
- Much less invasive than open surgery. It also reduces the risk of complications.
- Requires less time in hospital, usually requiring no overnight stay
- No surgical incision and no scar
- Slight risk of allergic reaction if using contrast material
- Any procedure that uses a catheter carries risks such as damage to the blood vessel, bruising or bleeding at the puncture site, and infection.
- Small chance embolic agent is placed in wrong location and deprives normal tissue of oxygen
- Risk of infection after embolisation
How Successful is Ovarian Vein Embolization?
Medical literature shows success in 90-95% of cases in relieving pain, either completely or partially. It is also cheaper than surgery and less invasive, making it a suitable option for patients.
You can find a detailed explanation of embolisation to treat pelvic congestion syndrome in the Cardiovascular and Interventional Radiology journal, where the author discusses the condition, treatment and outcomes at length.