How is Pelvic Venous Insufficiency (PVI) treated?
A pelvic ultrasound is generally performed prior to the venogram to exclude other potential problems with the ovaries or uterus. The diagnosis of pelvic venous insufficiency is then confirmed by a pelvic venography. If indicated, a treatment called Pelvic Venous Embolization can then be performed in order to relieve the abnormal pressure inside the pelvic veins. The venogram and embolization are performed on an outpatient basis and take about two hours.
The embolization procedure consists of inserting a thin, flexible, plastic catheter (or tube) into the jugular vein in the neck. Liquid contrast agent is then injected into the veins of the pelvis and special x-rays are obtained. These images allow the doctor to visualize the refluxing pelvic varicosities and seal them off using sclerosant and coils placed inside the abnormal veins. The catheter is then removed and a small dressing is then applied. After treatment, patients can often return to normal activity immediately.