Could your Chronic Pelvic Pain (CPP) actually be Pelvic Venous Insufficiency (PVI)? 

This year, we have had multiple patient success stories at Vascular and Interventional Physicians after treating women who were suffering from Pelvic Venous Insufficiency, or PVI. It is estimated that at least 10% of women in the US develop issues post-childbirth that can eventually lead to Pelvic Venous Insufficiency. The symptoms of PVI can be similar to Chronic Pelvic Pain, or CPP, and are often under recognized. Because of this, it can be possible that a patient diagnosed with CPP actually has PVI. Because the pelvic region involves multiple systems in the body, it is easy to receive multiple diagnoses for what are truly PVI symptoms. One of our patients, C.T., said: “I had been to every doctor known to man… from urologists, to gynecologists, to gastroenterologists… Little by little, I was losing hope as I continued to have excruciating pain without finding a solution.”

Together, we’ll examine common symptoms for Pelvic Venous Insufficiency, as well as the picture of a typical patient, the methods of diagnosis, and available treatment options.

Your Pelvic Pain and Discomfort may actually be Symptoms of Pelvic Venous Insufficiency (PVI)

Common symptoms of Pelvic Venous Insufficiency include: a feeling of chronic pelvic heaviness, continual pelvic pain and discomfort, difficulty sitting or standing for long periods of time, frequent urination, and pain during or after intercourse. One of our patients, Rachel, went from having occasional pain to consistent pain that would show up without notice: “I would get sharp pains that would stop me in my tracks, and I would be bent over [from the pain].” After suffering for years and years without resolution, she continued to seek out new doctors to get additional opinions.

Another patient, C.T., said that the heaviness and pain in her pelvis felt like a “concrete block wrapped in sandpaper,” and that it hurt to do all types of normal activity, including eating. Furthermore, she said: “it started to affect my mental state. Despite being an active person, I didn’t feel like doing things due to the pain and began feeling depressed.”

Don’t Settle for Pain Medications or Hormones to Treat your PVI 

Unfortunately, Pelvic Venous Insufficiency is sometimes under recognized as the root cause of Chronic Pelvic Pain by primary care physicians and gynecologists. Rachel shared that she went to doctor, after doctor, after doctor. “They all performed the same tests, and they all gave me the same answers: they could give me pain medication or hormone therapy. I finally couldn’t take it anymore and really lost my confidence in physicians at that point. I was feeling very frustrated and discouraged.”

What is occurring with PVI is instead of the ovarian veins bringing blood up and out of the pelvis, the veins are faulty and leak, causing blood to be pulled by gravity in the wrong direction. This causes dilation and swelling in the pelvic veins, creating varicose veins and causing pain and discomfort in the pelvic region. For C.T., she felt grateful to finally find a doctor who truly listened to her and who could identify the core problem, saying, “For the first time in my life, I was positive that someone might be able to help me. It was the first time I had felt any relief or hope with my condition.” Thankfully, our interventional radiologists at Vascular and Interventional Physicians (VIP) in Gainesville, Florida are trained in the diagnosis and treatment of PVI.

Characteristics of Patients Suffering from Pelvic Venous Insufficiency

Who is most likely to develop PVI? Patients who typically develop the disorder are women between 25 and 45 years’ old who have had 2 or more pregnancies and who have not yet gone through menopause; however, this is not always the case. Our patient Rachel had experienced two normal pregnancies and had already gone through menopause. Thankfully, at Vascular and Interventional Physicians, we offer minimally-invasive solutions for female patients that are suffering from this disorder that require no hospitalization and little down time.

Talk with Your Primary Care Physician or OB-GYN About Your Possible PVI

So, how do you go about diagnosing and treating PVI? If you’re experiencing the symptoms we have previously described and fall within the demographics of a typical PVI patient, it is possible that you may have the disorder. For next steps, talk with your primary care provider or gynecologist, and he/she can work with you to determine if you might have PVI. If it looks likely, he/she can refer you to an interventional radiologist at our VIP office in Gainesville, Florida.

Work with an Interventional Radiologist at Vascular and Interventional Physicians to Diagnose your PVI

At your appointment at Vascular and Interventional Physicians (VIP), you’ll meet with one of our interventional radiologists to determine if you do have PVI. To do this, your doctor may utilize diagnostic imaging to identify the root cause of your symptoms, including the use of an MRI or CT. If not already performed, transabdominal and transvaginal ultrasound may be used to measure ovarian vein sizes and reflux. Once he reviews your results, he will be able to give you a comprehensive diagnosis with possible treatment options.

Exploring Minimally-Invasive Treatment Options for Pelvic Venous Insufficiency at VIP

After your interventional radiologist has developed your unique treatment plan for addressing PVI, you may be a candidate for a pelvic vein/ovarian vein embolization (PVE/OVE), which is a minimally invasive solution for treating PVI. The embolization is a procedure that uses a catheter to block the blood supply to the faulty veins, causing them to shrink. Rachel worked with Dr. Bret Wiechmann at VIP in Gainesville who, “was very inviting and patient. He took his time to thoroughly explain what was going to happen [with my procedure].”

Most procedures only require moderate sedation and local anesthesia. To place the catheter, the interventional radiologist inserts a thin tube through the vein at the top of the thigh and uses X-Ray (fluoroscopy) to guide it to the vein. X-Ray dye is injected into the veins to identify the catheter position. Once confirmed, tiny coils and/or medications are injected into the blood vessels, which blocks blood flow to the leaky veins and causes them to shrink. C.T. also had a Pelvic Vein Embolization, and she couldn’t believe how quickly she felt relief. “I felt great after the procedure… like I had nothing wrong with me! My relief was instant, and I felt lighter right away. I’m hoping that others suffering from this disorder can read this and seek the treatment that they need.”

Schedule an Appointment at Vascular and Interventional Physicians Today!

Patients that undergo a Pelvic Vein Embolization can see results as quickly as 1-3 days, with minimal downtime. The procedure allows you to recover quickly and to return to a normal work routine within a week. If you think that you might have Pelvic Venous Insufficiency, reach out to your primary care doctor to begin the path towards relief today. Our interventional radiologists at Vascular and Interventional Physicians in Gainesville will be happy to assist you with your diagnosis, treatment and recovery! As C.T. says, “There’s nothing to lose by pursuing this avenue. This disorder is not publicized and is difficult to diagnose. I hope that other women can read my story and find a solution that will work for them. It could really save their life!”