What is it about?

30% of women with pelvic pain have pelvic congestion syndrome. 20% of women who have leg varicose veins have varicose veins in the pelvis causing them. Before 2014, patients used to go into hospital and have treatment of their pelvic veins under general anaesthetic or sedation. Since 2014, we have shown that patients can be treated safely in our clinic as out-patients, using local anaesthetic only.

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Why is it important?

Pelvic pain affects a great many women. However, most gynaecologists and family doctors do not recognise pelvic congestion syndrome (varicose veins in the pelvis). research has shown 1 in 3 women with pain in the pelvis has pelvic congestion due to these veins. Also, 1 in 5 women with leg varicose veins has varicose veins in the pelvis feeding into the leg varicose veins. Research shows that failing to find and treat these pelvic varicose veins is one of the commonest reasons that women get their varicose veins back again after treatment. The best way to treat these veins in the pelvis is to put metal coils into them to block them - "coil embolisation". This is done under x-ray control. Usually, this is done in a hospital under a general anaesthetic or sedation. However, we have shown in this paper, that at our clinic, it is safe for women to have this treatment as an out-patient procedure under local anaesthetic only. This reduces costs and risks associated with general anaesthetic or sedation.

Perspectives

Going into hospital can be a frightening - and expensive - process. Treatment of pelvic congestion and varicose veins in the pelvis is very specialist. Previous research from our clinic has shown that using our techniques, we can get very good long-term results. This research shows the results of progressing our treatment to be an out-patient treatment, in a specialist clinic, under local anaesthetic only. In the 2 years studied, there were no major complications and almost all of the patients had successful treatment. We have shown that using our techniques, it is safe to treat pelvic veins with coils in a clinic under local anaesthetic only.

Professor Mark S Whiteley
The Whiteley Clinic

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This page is a summary of: Pelvic vein embolisation of gonadal and internal iliac veins can be performed safely and with good technical results in an ambulatory vein clinic, under local anaesthetic alone – Results from two years' experience, Phlebology The Journal of Venous Disease, October 2017, SAGE Publications,
DOI: 10.1177/0268355517734952.
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