How do pelvic varices manifest?

Thevaricose veins in the pelvismay be responsible:
- pelvic congestion syndrome
- varicose veins on the perineum
- and/or an impact on the legs with varicose veins on the lower limbs.
 
What is pelvic congestion syndrome?

thepelvic congestion syndromeincludes all the symptoms related to venous stasis in thepelvic varices.
This stasis causes throbbing chronic pain, heaviness, typically increased with prolonged standing and at the end of the day. It can be increased just before and during menstruation.
Dyspareunia is often associated.

The blood seeking to escape from these incompetent veins, it can then move towards the perineum and the legs by leakage bridges causingvaricose veinsat these places.









































How is the diagnosis of pelvic varices made?

The diagnosis is suspected whenchronic pelvic painevoking apelvic congestion syndrome, the presence ofperineal varices, or during an ultrasound assessment carried out forvaricose veins of the legs.

The interventional radiologist in lyoncan see you in consultation to confirm the diagnosis and carry out the necessary morphological assessment before any treatment.

Pelvic varicesbeing frequent in women who have had several children in particular, it is important to make a concordant link between the exact anatomical situation of thepelvic varicesand the patient's symptoms.

ASpecialized pelvic MRI for these pelvic varices, with notably dynamic venous 4D sequences, will be carried out in pairs by Doctor Charles Mastier and his associates specialized in pelvic MRI from the IMVOC group (Dr Faure, Dr Mezzetta and Dr Buisson).

This MRI allows:
- de confirm pelvic varices
- to know the feeder veins responsible (ovarian, internal iliac etc.)
- to look for perineal leak points.
- in the event of chronic pelvic pain, this pelvic MRI will rule out differential diagnoses, particularly uterine fibroids and endometriosis.
- to eliminate iliac compression (cocket syndrome) or left kidney (nutcracker syndrome) or other rarer anatomical cause of obstacle to pelvic venous return
- and thus to perfectly prepare the treatment by embolization (a warning is worth two!).

In case ofperineal varicesanotultrasound-dopplerperformed by trained angiologistss to this pathology also helps a lot in precisely guiding the treatment.

























How is pelvic varices embolization performed?
 
The treatment of pelvic varices takes place in Lyonon an outpatient basis under conscious sedation.

L'operationis performed by ainterventional radiologistexpert in handling micro-catheters and in a treatment roomradiologyinterventional.

Local anesthesia is applied to the right femoral vein.

From this simple puncture, the radiologist will guide micro-catheters into the veins to first carry out an exhaustive assessment of the venous condition.

It is already very oriented by the imaging assessment carried out previously.

He will thus look for the affected veins, dilated and where the blood no longer circulates, as well as the leak points on the internal iliac system or the perineum.

He will then catheterize these places in order to occlude them using agentembolization.

The minimally invasive center-Lyon favors biological adhesives, because they ensure optimal visual control of the embolized areas, unlike sclerosant.

After the embolization, the catheters are removed and a dressing compressing the vein is applied for a few hours. You return the same evening with home treatments.

You are seen again a month later in consultation to judge the effectiveness of the treatment.
Sometimes several embolization sessions may be necessary.
















































Is pelvic varices embolization painful?​


Embolizationmay be painful for 2 to 7 days.

But this pain will be taken care of in advance so that you do not feel it.

During the embolization, you will be taken care of by an anesthesiologist for optimal comfort.

Back home, a home nurse will provide personalized support with painkillers and anti-inflammatories.

The recovery of activity is very fast, a work stoppage of a few days is recommended.