Pelvic varicose veins, also known aspelviccongestionsyndrome, are anunderdiagnosed vascular condition that may be the underlying cause of many cases ofchronicpelvicpainin women of childbearing age. At Hospiten Rambla University Hospital, the Endovascular and Interventional Radiology Department emphasizes the need to improveclinicaldetectionandsystematicallyincorporate itintothe differential diagnosis, with the goal of reducing diagnostic delays that, in many cases, can last foryears.
The condition is caused by the dilation and malfunction of the pelvic veins, leading to abnormal stagnation of blood flow in the area. This condition may be associated withsymptoms such aspersistent pelvic pain, a sensation of heaviness, worsening after standing for prolonged periods, and discomfort during sexual intercourse (dyspareunia), among others. In certain cases, varicose veins in the legs originate from pelvic venous insufficiency, so evaluation is recommended for patients presenting these symptoms.
Dr. Tobias Zander, head of the Endovascular and Interventional Radiology Service at Hospiten in the Canary Islands, states that “pelvic varicose veins remain a poorly recognized condition in routine clinical practice, which means that many patients go through multiple consultations without a diagnosis. When we correctly identify the venous origin of the problem, the endovascular approach allows forvery significant clinicalimprovementin most cases.”
Diagnosis Using Imaging Techniques
Diagnosing thiscondition requires specific imaging techniques, as itsclinicalpresentationcan be confused with other gynecological or digestive conditions. Among the most commonly used tests are Doppler ultrasound, CT angiography, and magnetic resonance imaging (MRI), which allow for a precise evaluation of thepelvicvenous network.
Definitive confirmation of the diagnosis can be achieved throughpelvicphlebography, aminimally invasive, high-resolutiontechnique that allows real-time visualization of venous behavior by administering contrast dye via acatheter.
Venous Embolization: Minimally Invasive Treatment
The standard of care in these cases is venous embolization, aminimally invasive endovascular techniquethat allows for the occlusion of the affected veins and the redirection of blood flow toward healthy veins, without the need for open surgery.
Venous embolization is performed under image guidance and is characterized by its safety profile andrapidrecovery. The experience in performing these techniques depends on the department carrying out these endovascular procedures, which directly influences the success of the treatment. Approximately 90% of patients experience a significant improvement in symptoms, and nearly half achievecomplete resolution of pain.
The Department, under the direction of Dr. Tobias Zander, is a leading center for the treatment of this condition in Spain, withover 20yearsof experienceand thepublication of its results in prestigious international journals (Zander T et al. The Transbrachial Venous Approach for Pelvic Congestion Syndrome Embolization: An Easy Way to Outpatient Procedure. Ann Vasc Surg. 2022 Jan;78:373-376.).
“The goal is not limited to treating a venous disorder, but to restoring the quality of life for patients who have lived with thisconditionfor yearswithout anaccurate diagnosis,”adds Dr. Zander.
Increased Clinical Suspicion
Hospiten Rambla University Hospital emphasizes the need to increase clinical suspicion in women withchronicpelvicpainof unknown cause, especially those with a history of pregnancy,geneticpredisposition,or associated hormonal factors.
Hospiten is committed to improving patients’ functional prognosis through early diagnosis and a specialized approach, which significantly reduce the time to treatment.
Tenerife, a leader in interventional radiology by 2026
In November of this year, Santa Cruz de Tenerife (Tenerife) will host the SERVEI (Spanish Society of Vascular and Interventional Radiology) Update Conference and the SIDI (Ibero-American Society of Interventional Radiology) International Congress, events led by Dr. Tobias Zander that will bring together more than 400 professionals from across Latin America and establish Tenerife as a national and international leader in the field of interventional radiology.
This article is an English translation generated with AI from the original Spanish content. While we review content for clarity, the information is provided for general informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for diagnosis or treatment.