Ovarian Vein Embolisation | Northern Beaches Interventional Radiology

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 reduces 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 the hospital until the 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.

How much activity should I do after the procedure?

On your return home you could go for a short 10-minute walk the same evening. Use pain relief medication, such as Panadol, if needed and rest if required.

Over the next week, you should make a point of remaining mobile. Avoid sitting or standing for extended periods, and any non essential air travel over the following month.

Is ovarian vein embolisation safe?

Yes, ovarian vein embolisation has been shown to be a safe and effective treatment for pelvic congestion syndrome, with a technical success rate of 95-100%.

What are the Benefits and Risks of Ovarian Vein Embolisation?

Benefits

Embolisation is highly effective for controlling bleeding.
It is highly successful in reducing symptoms.
It is much less invasive than open surgery. It also reduces the risk of complications.
It requires less time in the hospital, usually performed as an outpatient procedure.
There is no surgical incision and no scarring.

Risks

There is a slight risk of an 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.
There is a small chance the embolic agent is placed in the wrong location and deprives normal tissue of oxygen.
There is a risk of infection after embolisation.

Does Ovarian Vein Embolisation Affect Fertility?

A 2019 study found that ovarian vein embolisation in patients with pelvic congestion syndrome is a safe and effective method for those trying to become pregnant - of the 12 women who underwent OVE, 6 of them went on to have a successful pregnancy. The authors concluded that more research is needed to properly determine the application of this procedure to discussions of fertility.

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.

Ovarian Vein Embolisation for Pelvic Congestion Syndrome