Story

Pelvic venous reflux. We've all heard of varicose veins of the legs but it's due to a problem with the veins all over the body. When you're standing up anything below the heart can be dilated and varicose. So you can get varicose veins in men of the testicular vein and in women they get it of the ovarian vein. And any of the veins in the pelvis can be dilated and ache and be painful just like the veins of the legs that we recognise as varicose veins. Sometimes we want to treat the varicose veins in the legs but they keep recurring because the leak in the veins is actually higher up in the pelvis and that needs addressing in its own right. And sometimes it's the cause of heavy periods, of haemorrhoids, of low back pain worse in the week before period starts, vulval varices in pregnancy, and pain and swelling after sex, as well as varicose veins in the legs. We address this by first of all doing diagnostic tests with duplex ultrasound scanning, and ultimately dynamic venography, a way of examining the veins directly and seeing whether they are refluxing and damaged, and whether or not they would benefit from being embolized, which is essentially blocking the pathways off that are causing the leakage and causing the swelling and dilatation of the veins that causes the pain. And that's called pelvic venous embolization.