Pelvic Venous Disorder PeVD

This information aims to provide patients with an overview of the symptoms and diagnosis of pelvic venous disorders (PeVD). PeVD can also be referred to as pelvic congestion, pelvic insufficiency or pelvic reflux.

Pelvic venous disorders consist of 2 types of conditions:

  • venous reflux: where the valves in the pelvic veins are damaged; and
  • obstructive disease: where the veins are narrowed.

Both cause enlarged, varicose-type veins around the uterus and ovaries, leading to pelvic pain. They may also cause visible varicose veins around the vulva, vagina, inner thigh, sometimes the buttock and down the leg(s).

Symptoms

The symptoms are often non-specific, making it hard to spot, causing many women to live with PeVD for years before diagnosis (Ref 1). PeVD is usually associated with the following symptoms (Ref 2 & 3):

  • Pelvic pain for more than 6 months with or without visible varicose veins in the thigh, abdomen, vulva or leg swelling.
  • Pain provoked by gravity- Pain that worsens across the day, following prolonged periods of standing or pain that is relieved by lying down.
  • Prolonged post coital ache.

You should consult your GP or Gynaecologist if you have these symptoms and have had other possible causes of pelvic pain ruled out.

Diagnosis

Transvaginal duplex scanning (TVUS) and abdominal ultrasound (US) may be useful to detect the abnormal veins and their blood flow . Once you have been referred to the Vascular department they might discuss whether further investigation with magnetic resonance imaging (MRI) or Venography may be necessary.

Further information

For more detailed information about this condition and the treatment options, refer to the British Society of Interventional Radiology (BSIR).

BSIR Pelvic Congestion Syndrome and Pelvic Vein Embolisation

References

1. https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/symptoms-causes/syc-20354368

2. The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders Meissner, Mark H. et al. Journal of Vascular Surgery: Venous and Lymphatic Disorders, Volume 9, Issue 3, 568 – 584

3. Khilnani NM, Winokur RS, Scherer KL, Meissner MH. Clinical Presentation and Evaluation of Pelvic Venous Disorders in Women. Tech Vasc Interv Radiol. 2021 Mar;24(1):100730. doi: 10.1016/j.tvir.2021.100730. Epub 2021 Apr 16. PMID: 34147196.

More Information

Pelvic Venous Congestion Syndrome   Dr Shaheen Dixon, Dr Charles Ross Tapping, Dr Wei Chuen Liong and Dr Dinuke Warakaulle

Departments of Radiology, John Radcliffe Hospital, Oxford and Stoke Mandeville Hospital, Aylesbury

https://www.bsir.org/patients-1/useful-terms/pelvic-venous-congestion-syndrome/

Review Article, Open access  20 April 2023 Pelvic venous congestion syndrome: female venous congestive syndromes and endovascular treatment options Elika Kashef, Elizabeth Evans et al:

https://cvirendovasc.springeropen.com/articles/10.1186/s42155-023-00365-y