Tiny coils that go into your NECK to ease pelvic pain
AN ESTIMATED 1.5 million women in the UK have ‘varicose veins’ in their pelvis. Heather Scott, 25, a store manager from Hampshire, has just had a new procedure to treat hers, as she tells ROGER DOBSON.
MTHE PATIENT
y problems first started in september 2013, with stomach bloating, and then all sorts of other symptoms hit me. I had cramping and stabbing pains in my pelvis, severe lethargy and sex became really painful.
I went to my Gp a week later. Initially he thought I might be pregnant, but as a test showed I wasn’t, he prescribed some painkillers.
but the pain continued and was so intense that between september 2013 and November 2015, I saw various Gps about 40 times.
As well as the pain, my stomach started to bloat and I found it hard to eat. I struggled even to eat child-sized portions. The stabbing pains in my abdomen made it difficult to walk or sit down and my back started to ache.
I was referred to a gynaecologist and in september 2014 was sent for a surgical laparoscopy (an investigation of the pelvis using a tiny camera) under general anaesthetic and that’s when they found I had enlarged ‘varicose veins’ in my pelvis — something called pelvic congestion syndrome.
It was a relief to get a diagnosis. Doctors suggested I take the contraceptive pill back-toback for a few months. This would stop my periods and reduce the blood pooling in the varicose veins in some cases.
but it didn’t help. my life continued to be a misery. my Gp sent me to an interventional radiologist who gave me an mrI scan, having first injected contrast dye into my veins. It showed the veins in my pelvis were hugely enlarged.
I was advised to go to The Whiteley Clinic in london, a private clinic specialising in vascular treatments. I was happy to try anything. They performed an ultrasound scan which found three of the four major veins in the pelvis were varicose veins, which is why my symptoms were so severe.
They
said they could do a pelvic vein embolisation. This would involve inserting tiny metal coils to block off the varicose veins. These would ultimately shrink, but other veins would take over their job.
The procedure would be done under local anaesthetic by entering a catheter through my neck as this gives a straight route to the pelvis. A TV screen is used to guide it, and I could watch what was going on via a screen.
I could feel the contrast dye, which is used to monitor the position of the catheter (flexible tube), being injected. It wasn’t unpleasant — I just had a warm feeling.
When the coils were inserted I felt a sharp scratch.
once the procedure was completed, I was able to walk to the recovery room and half an hour later I was allowed to go home. I knew within days that the procedure was successful. For the first time in years, I could eat a normal, adult-size meal and in around six months, I was symptom free.
I am now living the life of someone in their 20s again.
THE SPECIALIST
DaviD Beckett is an interventional radiologist at the Whiteley clinic, London, and the Royal Bournemouth and christchurch NHS trust. pelVIC congestion syndrome is caused by the veins that serve the womb and ovaries becoming enlarged.
The swollen veins put pressure on nerves and can lead to pain in the pelvis. They may also irritate the bladder or the bowel and cause bloating.
This pain may get worse during the day, particularly after prolonged standing as this encourages the blood to pool.
pelvic congestion syndrome is often diagnosed in women under 40 who have had more than one pregnancy. The pressure of pregnancy can lead to varicose veins, but they can also be genetic.
research suggests that up to 40 per cent of women in the UK have chronic pelvic pain, and 40 per cent of them will suffer from pelvic congestion syndrome. We estimate as many as 1.5 million women in the UK are affected.
Although men can get it too, it is less common. pelvic congestion syndrome can be diagnosed with a transvaginal duplex ultrasound scan. This uses soundwaves to spot faulty blood flow, a sign of varicose veins. That enables us to pinpoint the area to treat.
The idea behind vein embolisation is to plug and destroy the varicose veins.
The procedure is available in some Nhs centres, but the diagnostic transvaginal scan is available at limited centres.
To perform the embolisation the patient is given a local anaesthetic on the side of the neck and we make a tiny puncture in the skin there to gain access to a vein.
A catheter is inserted and navigated to the veins in the pelvic area, identified with an ultrasound scan. We inject a contrast dye into the vein to monitor the catheter progress.
Inside the catheter is a length of thin metal alloy and when we have confirmed that we have found the right vein, we release the metal strip from the catheter and roll it into the vein where it repeatedly coils.
The coils clump together and stop blood flow in the vein and over weeks the pelvic varicose veins shrink. The symptoms should improve over six weeks.
heather had ten coils in three veins and the procedure took just under an hour. We perform a second scan six to 12 weeks later to check the treatment. tHe procedure costs £3,000 to £5,000 privately.