Varicose Veins Originating in the Pelvic Region
Most people think of varicose veins as a condition that occurs in the legs. That certainly was the case for Marylin of Orange County, CA, until she found out she was one of 15% of women with varicose veins whose condition originates in the deeper veins of the pelvis. In fact, many women with varicose veins in the legs have sought treatment from doctors who treated the leg veins only, not realizing the condition originated in the pelvis, which led to a recurrence of the leg varicose veins.
Ovarian veins in the pelvis join the inferior vena cava and the left renal vein in the legs. When the valves in the veins become obstructed or damaged, it affects the flow of the blood heading back to the heart, the blood then flows backwards (i.e. the wrong way, away from the heart). This causes the varicose veins in the pelvis area, often leading down the thigh and leg area, and resulting in significant pain.
Marylin, like many women that have had two or more children, was a high risk for Pelvic Venous Congestion Syndrome, which is theorized to be caused by pressure on the pelvic veins from the weight of the baby in the womb, accompanied by increased blood flow to the area during pregnancy. Venous blood flow in the area may also be obstructed by polycystic ovaries.
If Marylin did not investigate further, she may have become one of many women with varicose veins in the legs who had to keep going back for recurring varicose vein treatments, as the cause of the varicose veins originating in the pelvis is often undiagnosed. Luckily, Marylin’s research brought her to the San Diego Vascular Center, which is only a short drive from Orange County for varicose vein treatment.
Symptoms may include generalized chronic, aching pain in the pelvic or lower abdominal area, sometimes accompanied by feelings of heaviness or fullness of the legs. Intensity of pain may vary according to level of physical activity, menstrual cycle, or fatigue. In Marylin’s case, standing for long hours at her job led to marked increase in pain symptoms, whereas lying down mitigated the pain.
Visual examination often indicates varicose veins in the pelvic or upper/inner thigh region. Transvaginal Ultrasound has been found to be effective in detecting varicose veins of the pelvic veins, as well as MRI imaging. Imaging is a critical step to determine in which veins the problem originates, so they can be targeted for treatment. Pelvic venography is often used for precise imaging, either prior to pelvic varicose vein treatment, or at the time of treatment.
Most doctors will begin with hormone therapy or drug treatment (medroxyprogesterone acetate or Goserelin are effective in decreasing vein diameter and minimizing varicose veins) before deciding to move forward with invasive treatment. Treatment of pelvic varicose veins or pelvic congestion syndrome is similar to treatment of varicose veins in the legs, using either sclerotherapy or pelvic vein embolization.
Pelvic vein embolization is minimally invasive, and occurs under local anesthetic. X-ray imaging is utilized to help the vascular surgeon or interventional radiologist through the process of inserting a small catheter into the afflicted veins, whereby sclerotherapy, coils, or both, will be injected into the vein to close off the veins with faulty valves. The body responds by naturally rerouting blood flow to healthy veins.
There is minimal discomfort during the procedure; most patients describe only sensations of pressure, and no pain. Patients can return to normal activity levels soon after the procedure, with little or no down time, although it is recommended to rest for 48 hours following the procedure.
The San Diego Vascular Center specializes in diagnosis and treatment for any and all vascular health issues for patients in San Diego County, Orange County and Riverside County. For more information or to set an appointment, please contact us.