Pelvic Vein Embolization
Pelvic Vein Embolization
When should I be submitted to the embolization treatment?
The pelvic vein treatment is usually performed when some type of symptoms arises, and it is started with medication that helps decrease veins dilatation.
Besides, if the symptoms don’t improve with embolization or if they are very intense, then the possibility to perform a pelvic vein embolization must be considered.
Embolization is a procedure that consists in inserting a very thin catheter through the vein up to the varicose veins area, where a substance that decreases the varicose veins and increases the force of the veins walls is released.
The Embolization treatment is performed with phlebography, an interventional radiology technique where a catheter (a 1 to 2 mm small plastic tube) is inserted into the veins and injects contrast material to study pelvic veins.
It allows not only to diagnose the presence of pelvic varicose veins and pelvic venous congestion syndrome but also to treat the varicose veins with embolization, in the same session.
Embolization is the name given to the treatment with a catheter, where the obstruction or pelvic varicose veins clogging is provoked. With embolization, the catheter goes to the pelvic varicose veins, which are occluded or covered with specific materials for this purpose.
How is the Embolization treatment performed?
Pelvic vein Embolization is a minimally invasive procedure, painless, with prompt recovery, and is an outpatient treatment. That is to say, the patient comes in in the morning and leaves in the afternoon on her own like she was not submitted to any treatment.
Pelvic vein embolization on pelvic venous congestion syndrome treatment usually includes a phlebography (selective angiography) of the ovarian vein, under local anesthesia, through a groin or neck vein, using a 1 to 2 mm very small plastic tube (catheter).
The catheter is placed on the inferior vena cava, then on the left renal vein, and finally, super selectively, on the ovarian vein, under angiographic control.
It is confirmed the existence of pelvic varicose veins on the dependency of ovarian veins by the reflux of the contrast material injected through the catheter, which emphasizes with Valsalva maneuver (push with the abdomen to increase the intra-abdominal pressure).
After confirming the pelvic varicose veins diagnosis, the catheter moves forward to the left ovarian veins distal, and the pelvic vein embolization is performed.
How is the follow-up after the embolization?
Most patients don’t feel any pain after Embolization treatment. The recovery room is in a room next to the angiography room, where the embolization was performed.
A patch is placed on the groin or neck, depending on the area where the catheter was inserted. The patient must rest for 2 hours before starting walking again.
Usually, patients don’t feel pain and can be discharged on the same day of the procedure, meaning that they are ambulant patients (don’t need to be admitted for one night).
When it comes to patients treated for pelvic vein embolization, the recovery is prompt. Patients can eat right after the treatment and have no pain or bleeding.
Practically all patients are discharged on the same day of the procedure and can go home on their own. The recovery is prompt and painless.
Patients treated with pelvic vein embolization have painless and prompt recovery and don’t usually need any type of medication.
What materials are used during the embolization?
There are several types of agents used to embolize ovarian veins: embolization coils, balloons, sclerosing agents, and glue.
In our center, we have extensive experience on pelvic vein embolization in pelvic venous congestion syndrome treatment, using sclerosing such as polidocanol.
Patients can leave the hospital about 2 hours after the pelvic vein embolization, painless and with prompt recovery.
They can return to their normal professional activity the next day.
Is it possible for the materials used in the procedure to move to other areas?
With all the experience and care that we have and based on the embolic agent that we use, that risk is practically null.
That is to say, all the material that we use during the pelvic vein embolization stays on the pelvis and does not move to other body areas.
Is pelvic vein embolization/pelvic venous congestion syndrome safe and effective?
Pelvic vein embolization in pelvic venous congestion syndrome treatment is very safe, without associated complications, and with excellent clinical success rates.
Clinical successful rates differ from 96.7%-98%, with full remission of the symptoms between 57.9% and 58.5% of the patients, and partial remission in over 90% of patients. Chronic pelvic pain without evidence of any pathology is a common gynecological problem.
The non-specificity of symptoms and the need to perform an invasive exam to confirm a diagnosis make pelvic venous congestion syndrome little diagnosed.
Women with chronic pelvic pain and with no apparent disease can have pelvic venous congestion syndrome, particularly when exacerbated by the orthostatic position, by walking, and sometimes associated with vulvar varicosities and lower member varicose.
Pelvic vein embolization in pelvic venous congestion syndrome allows to establish a definitive diagnosis and has the advantage to enable therapeutic embolization on the same procedure.
From our experience, pelvic vein embolization on pelvic venous congestion syndrome is safe and effective, and doctors and patients must be alerted to the existence of this syndrome, which is so hard to diagnose, and to the best diagnostic and therapeutic approach to use.
What is the connection between pelvic varicose veins and my sexual function?
Since pelvic varicose veins can cause pain during intercourse and vulvar varicosities, embolization treatment can improve sexual function and pleasure during intercourse.
With pelvic vein embolization, the patient no longer feels pain during intercourse, and vulvar varicosities disappear, resulting in better intercourse for the patient.
When do I start noticing improvements?
Improvements start to be noticeable one week after the embolization. The feeling of pain and pelvic heaviness that the patient had, disappears gradually in the days following the embolization treatment.
How long does the treatment last?
Usually, the treatment is permanent, that is to say: it lasts forever.