Pelvic Venous Congestion (PVCS) Treatment

Pelvic Venous Congestion SYNDROME (PVCS)

What are the treatment options for PVCs? Available treatment options for PVCs include pain-relieving progestin hormone drugs, ovarian function-blocking Gonadotropin-releasing hormones, vein embolization, and surgery to rid of damaged veins, uterus, and ovaries. Customarily, your doctor will start you on the medications first to relieve pain. If the medications fail, then they may advise on the next step, usually the invasive options. Vein embolization is the most commonly used procedure. Here’s a look at what it involves:

Pelvic Venous Embolization

Treating PVCS diseases like pelvic and labial varicose veins requires resolving the backward follow of blood in the ovarian and pelvic veins through embolization. Embolization is an outpatient procedure that uses catheter technology to access the venous system to the problematic ovarian veins. The procedure is painless and requires no major incisions. The physician embolizes each problem vein (blocking blood flow) with vascular plugs or coils. Doing so permanently seals off the varicose veins, diverting blood flow up through healthy veins. The physician will also deliver sclerosing medication to lower the pressure in the pelvic veins and relieve the pain. Once blood can flow smoothly through healthy veins in the pelvic and labial area, the pain disappears. Patients can usually return to work and light activities the day following the procedure and see a full recovery in about one week; at least 7 in 10 women who undergo the procedure report feeling better. This procedure is usually performed by a trained interventional radiologist in the X-ray department.

Sclerotherapy

Sclerotherapy is a minimally invasive procedure that injects sclerosing solutions into the veins. It is used to treat spider, reticular and varicose veins. It also blocks the unsightly or non-functioning veins to gradually improve appearance. This generally involves multiple treatments over the course of several months.

Radiofrequency Ablation (RFA)

Radiofrequency Ablation is a minimally invasive, image-guided procedure used to treat varicose veins. An RFA utilizes high-frequency radio waves directed through a thin tube to create intense heat within the varicose vein. This closes up the problem vessel so blood cannot flow through it, redirecting blood flow into healthy veins to allow the blood to return to the heart. Eliminating the unhealthy vein reduces the vein bulging and minimizes leg pain and swelling. It is performed as an outpatient procedure with minimal recovery and discomfort.

When Should I Contact My Doctor?

Some women have enlarged veins with no symptoms; others have enlarged veins that cause pains and aches. In most cases, these don’t require a medical emergency. The symptoms should reduce as you head into menopause. However, in case of chronic, unbearable pain, nothing is stopping you from seeking medical help. In fact, see your healthcare giver right away for help.

To get the most out of the consultation, here’s what to do:

Know the purpose of the visit and what you want to get from it
Before visiting the doctor, put down questions you need them to answer.
Bring company along to help ask questions and note down points from the doctor.
Write down the name of the diagnosis, its tests, and treatment options explained by the doctor. Also, take notes of any new instructions during each visit.
Know the reasons for new medication prescriptions, their benefits, and their risks.
Inquire whether it’s possible to treat your condition another way
Know why and what the results of a test procedure mean
Ask what will happen if you don’t undergo testing or take medication.
Ask whether a follow-up appointment is available and note down the visit’s time, date, and reason.
Ask the doctor for their contacts in case you need a further chat.

Pros and Cons of Pelvic Vein/Ovarian Embolization Procedure:

Benefits

- Embolization of the ovarian vein or pelvic vein has already been demonstrated to be a safe procedure for relieving pain sensations and improving varicose vein appearance.
- Embolization helps shut off affected veins, easing pressure from them, so they reduce in size.
- It’s a minimally invasive technique requiring only a tiny incision in the skin. You won’t even need stitches.
- Fewer complications than traditional surgery. You also lose less blood, and the incision mark is not even visible. You won’t also need to stay in the hospital for long.
- 85 % of women who undergo the procedure report feeling much better within 14 days of the operation

Risks

- You may be allergic to the iodine-based dye and a contrast agent used to take detailed images.
- A small number of women develop infections after embolization.
- Since the procedure involves placing a tube inside blood vessels, it may damage them or cause bruising and bleeding at the point of incision.
- if an embolic agent migrates to the wrong place, it may cut off the oxygen supply to the tissue, i.e., non-target embolism
- There’s a 10 % chance that the varices may develop in the veins again.
- It exposes the ovaries to radiation. However, studies have not found any links between the procedure and infertility or abnormal periods.

What Happens After the Procedure?

The doctor will monitor your blood pressure and heart rate. Some patients suffer slight pain or discomfort following the surgery, which can be managed with simple medications taken by mouth or intravenously through the cannula.

Bed rest is advisable for a short period after the procedure. Most patients are cleared to leave the hospital after 4 hours. However, if you’re in significant pain, you might want to stay for longer and get extra care.

Once discharged, expect to resume your normal activities within a few days; however, don’t drive within the first week following the procedure. Of course, you can wait for longer in case of groin discomfort and get medical care too.

After your operation or therapy, your doctor may urge a follow-up scan and checkup. This is to determine whether the operation was successful and address any changes or adverse effects you may have noticed following the treatment. Just like other varicose veins on the leg, engorged veins in the thigh, vulva, buttocks, etc., may need to be treated separately.

The enlarged veins should gradually reduce in size within a few weeks by preventing reflux in pelvic veins. Even the vulvar varicose veins should disappear. You can also seek treatment for any varices in the lower legs. Various safe treatment options can be used to rid of the condition for good. However, seek treatment for other vein varices only after dealing with pelvic vein varices to reduce the chances of the condition coming back in the future. After treatment, any symptoms you’ve been experiencing due to the vein varices should go away.

How to Prepare for Pelvic Vein Embolization?

You will need to have your warfarin medication altered if you are taking any. Consult with a doctor for details.
Keep a list of your medications, even the herbal ones, and inform your doctor of any allergies, including allergic to the iodine dye.
Inform your doctor of any recent medical issues, illnesses, or if you are pregnant. Pelvic venography and vein embolism involve the use of X-rays; you don’t want the fetus exposed to the radiation.
Pack comfortable clothes; you will also be given a gown at the hospital for use during the procedure.

OUR PATIENTS SAY

Dr De Young is personable and thorough in his explanations. Exceptional.

James R.

I am pleased to recommend La Jolla Vein & Vascular. I am in the process of receiving treatment there. The entire medical staff are super friendly, welcoming and very helpful. Everyone is courteous, including the physicians. I’ve had one doctor follow my case. He’s the one who always treats me at appointments and closely follows my health. I am very comfortable going there. Would go again if needed and encourage anyone who’s thinking of making an appointment to do so asap. You’ll see what a wonderful experience it is. It’s the people who make it so special!

Monica M.

From my greeting at the front desk to the ultrasound and visit with the doctor, I received excellent care. It’s clear they care about their patients and all the staff couldn’t have been nicer or more helpful. I also appreciate how much time the doctor spent with me to explain the results and the next steps. I would definitely recommend this office to friends with vein issues.

Anne S.

We were early and didn’t have to wait at all. The tech that did my husband’s ultrasound, Monica, was very accommodating with my husband’s Parkinson’s. Doctor Lucas whom we hadn’t seen before, came to us instead of making my husband walk down to another office. She spent a lot of time getting caught up on Steve’s background issues/conditions. I was impressed by this medical group before, so I was surprised that the staff was even better this time around; I honestly didn’t think there was room for improvement!

Linda N.

I have been having leg treatments for several months now La Jolla Vein Care. Every time I go to an appointment; the staff is so friendly and takes such good care of me; always informative; not in a rush and always friendly (especially Alejandra & Anna to name a few). Of course Dr. Lucas is amazing. The treatments have changed my life. Overall this has been an incredible experience.

Brigid Z.

Beautiful facility! I walked in without an appointment and they took me right away! It was even the end of the day…I was so grateful…Every single person was soooo pleasant! Super impressed ❤️

Susan M.

Highly recommend! Entire staff are warm& friendly, professional and accommodating. The doctor took the time to thoroughly explain everything and encouraged me to ask questions. I never felt rushed. Significantly better experience than the other 2 vein clinics I’ve been to on the east coast. I wish I could’ve just come here from the beginning.

The staff kept you informed as to when you would be seen and the wait was not too long. Emily took care of my ultrasound and was very accommodating giving me an extra pillow and playing a video to watch. The office is very courteous and professional- Nadia answered our questions and offered us a bottle of water. I have been seeing Dr. Bunke, but now Dr. Lucas and will continue coming to La Jolla Vein Care!

Rebecca D.

I had the best experience at La Jolla Vein Care. Dr.Bunke is an amazing doctor with the best bedside manners, she truly cares about her patients, she explained everything to me. My procedures where so easy I was impressed how painless and fast my appointments. Anna M was very helpful scheduling my treatments and checking on me to make sure all of my questions were answered. I am very pleased thank you !!! I truly recommend La Jolla Vein Care!

Henda S.

Everyone here is so nice! Usually front desk medical personnel are so rude. The front desk ladies Alejandra, Anna, and I think her name is Liz, went above and beyond to take care of me and my insurance issues. The techs are great too! Rachel and a male technician assisted me…both of them implemented different techniques to make me feel more at ease during an uncomfortable and painful process. These procedures were rough…and I am grateful everyone was so sweet to me. Thanks again.

Melissa B.

When I arrived for the first time, I could barely walk. My legs were red and swollen. After my treatments, I can now walk again. I’m so thankful to the doctor and his staff. They are caring, supporting and knowledgeable about my issues. Five Stars all the way!!!!

Pamela M.

La Jolla Vein care has the best staff ever. They are so nice, accommodating and professional!! Dr. Bunke is the best doctor that I ever seen. She is so friendly upfront and has the best bed side manner. I thank this office for letting me be their patient. 💜. Plus they are so careful with COVID which I really appreciate!!!

Darlene H.