PELVIC VENOUS INSUFFICIENCY

Find relief from chronic pelvic pain and reclaim your quality of life

If you’re struggling with chronic pelvic pain, you may be suffering from a condition called pelvic venous insufficiency (PVI). At VIE, our team of experts is dedicated to providing accurate diagnosis and effective, minimally invasive treatments for PVI and other pelvic venous disorders (PeVDs). We understand the significant impact PVI can have on your daily life, and we’re here to help you find lasting relief.

Definition

What is Pelvic Venous Insufficiency?

PVI is a condition characterized by venous hypertension in the pelvis, caused by venous obstruction or valve failure, leading to the dilation of pelvic venous plexuses. PeVDs, including PVI, can cause a range of symptoms, such as chronic pelvic pain, lower extremity venous outflow obstruction, and varicosities of the labia and posterior thigh.

Risk Factors

Causes of PVI:

PVI can be classified as primary or secondary based on the underlying cause.

Primary PVI: Pelvic venous hypertension from reflux in the ovarian and internal iliac veins secondary to valve failure or absence of valves

Secondary PVI: Pelvic venous hypertension from reflux in the ovarian and internal iliac veins secondary to venous compression or obstruction of the iliac and left renal veins, redirecting normal venous blood flow through the pelvic venous plexuses

Accurate diagnosis of PVI requires a comprehensive evaluation by a specialist familiar with the complex anatomy and physiology of the pelvic venous system. At VIE, we use state-of-the-art diagnostic tools, including:

Transvaginal ultrasound (TVUS): The primary imaging modality for visualizing pelvic venous anatomy, dilation of venous plexuses, and documenting venous reflux
Transabdominal ultrasound (TAUS): Used to identify venous compression syndromes in appropriate patients
Computed tomography (CT) and magnetic resonance imaging (MRI): Secondary imaging tools that provide excellent anatomical information about the venous system and potential vascular compression

Symptoms

Chronic pelvic heaviness, achiness, or tiredness
Low back pain
Painful menstruation (dysmenorrhea)
Pain during or after intercourse (dyspareunia)
Urinary frequency, urgency, or discomfort (dysuria)
Varicose veins in the vulva, perineum, buttocks, or thighs

Treatment and Benefits

Treatment options for PVI: At VIE, we offer minimally invasive, targeted treatments for PVI, including:

Embolization: A procedure that involves blocking abnormal veins to reduce venous reflux and alleviate symptoms
Venous stenting: A technique used to open compressed or obstructed veins, restoring normal blood flow
Combination therapy: In some cases, a combination of embolization and venous stenting may be recommended for optimal results

Our team of interventional radiologists has extensive experience in performing these procedures, ensuring the best possible outcomes for our patients.

If you’re experiencing symptoms of chronic pelvic pain or have been diagnosed with PVI, contact VIE to schedule a consultation. Our specialists will work with you to develop a personalized treatment plan that addresses your unique needs and helps you reclaim your quality of life.

What to Expect

Listen to Dr. Cumming discuss pelvic venous disease on the Back Table Podcast

Dr. Michael Cumming, an expert in pelvic venous disorders, shares his insights on diagnosing, planning, and managing Pelvic Congestion Syndrome (PCS) in a two-part series on the BackTable Podcast. Alongside Dr. Mark Meissner, he covers accurate diagnosis, advanced imaging techniques, personalized treatment plans, minimally invasive treatments, and the importance of post-procedure follow-up and ongoing management.

REFERENCES

Meissner, M. H., Khilnani, N. M., Labropoulos, N., Gasparis, A. P., Gibson, K., Greiner, M., … & Nicolaides, A. (2021). The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 9(3), 568-584. https://doi.org/10.1016/j.jvsv.2020.12.084
Knuttinen, M. G., Xie, K., Jani, A., Palumbo, A., Carrillo, T., & Mar, W. (2015). Pelvic venous insufficiency: imaging diagnosis, treatment approaches, and therapeutic issues. American Journal of Roentgenology, 204(2), 448-458. https://doi.org/10.2214/AJR.14.12709
Antignani, P. L., Lazarashvili, Z., Monedero, J. L., Ezpeleta, S. Z., Whiteley, M. S., Khilnani, N. M., … & Wittens, C. H. A. (2019). Diagnosis and treatment of pelvic congestion syndrome: UIP consensus document. International Angiology, 38(4), 265-283. https://doi.org/10.23736/S0392-9590.19.04237-8