Pelvic Vein Embolisation

What is pelvic vein embolisation?

Veins in the pelvis can leak in exactly the way leg veins do. When the ovarian (gonadal) or internal pelvic veins reflux, blood pools in the pelvic venous plexus — pelvic congestion syndrome. Embolisation closes the faulty veins from within: through a catheter, the refluxing vein is sealed with coils, sclerosant or both, decompressing the congested plexus while normal drainage routes take over.

Who it may suit

The classic picture is chronic pelvic pain — present most days for six months or more — that worsens with prolonged standing, through the day, or around periods, sometimes with a dragging heaviness. Two visible clues make the diagnosis worth chasing: varicose veins appearing around the vulva, buttock or upper inner thigh, and leg varicose veins that keep recurring after technically sound treatment — often because they are being fed from above, out of the pelvis. It is a diagnosis worth considering precisely because it is so often missed: pelvic pain has many causes, and the venous one is the one a gynaecological work-up can overlook.

What the procedure involves

• Confirmed first on imaging — ultrasound, and usually CT or MR venography to map the refluxing veins
• Performed through a single needle puncture at the groin or neck, under local anaesthesia with sedation, as a day procedure
• The refluxing veins are catheterised and embolised; associated vulval or thigh veins can be dealt with by sclerotherapy afterwards

What to expect afterwards

A dull pelvic ache for a few days is common and settles with simple analgesia. Improvement in the dragging pain typically develops over weeks to a few months. Coil migration and non-target embolisation are uncommon but recognised risks; recurrence of symptoms can occur if additional refluxing channels open over time.

Is it right for me?

If long-standing pelvic pain has defied explanation — or your leg veins keep coming back — the pelvic veins deserve a look. At consultation the pattern is mapped with ultrasound, and I go through whether the imaging supports a venous cause before any treatment is discussed.