Living with PeVD
Pelvic Venous Disorders (PeVD) is a cruel condition, causing pain and distress to millions of women.1 The symptoms are often non-specific, so it can be hard to spot, causing many women to live with PeVD for years before diagnosis.2
PeVD can be successfully treated. The first step is to understand more about what PeVD is.
Let’s help women with PeVD get timely diagnosis and treatment. Then they can get back to living the lives they deserve.
Because PeVD have so many non-specific symptoms, it’s easy to think that they could be something different. These are some of the more commonly-diagnosed conditions that PeVD can appear to be:
• Endometriosis
• Cancers of the reproductive tract
• Ectopic pregnancy
• Pelvic adhesive disease
• Sexually transmitted infections
• Uterine fibroids
• Miscarriage
• Ovarian cysts
PeVD occurs more frequently in patients who have had children.3
The symptoms tend to be relieved by lying down (so may be less noticeable in the mornings).4
A PeVD patient may have a history of upper leg or vulval/perineal varices.4
Historical nomenclature for pelvic venous disorders:
• Failed to recognize the complex and interrelated pelvic venous circulation
• Contributed to misdiagnosis and poor treatment outcomes
• Hindered clinical research
Diagnosis and treatment of PeVD Transvaginal Duplex Scanning
PeVD are diagnosed through a Transvaginal Duplex Scanning (TVS) and Venous Duplex Ultrasound3.
When requesting imaging, insist the sonographer provides visualization of any varices present.
If there is any suggestion of varices, consider referring the patient to a vascular surgeon or an interventional radiologist for further assessment.
Example patient. Transvaginal images show extensive, dilated, slow-flowing veins measuring 8.8 mm on the top, and 9.6 mm on the bottom.
Interventional radiologists and vascular surgeons offer real hope for PeVD patients3,5
Interventional radiologists and vascular surgeons use a variety of products (e.g. coil or liquid embolization) to close the affected vessels and allow blood to divert to healthy vessels, thereby relieving the symptoms caused by varicose veins.
• A safe procedure that’s highly effective and less invasive than other options
• Patients can be treated typically as day cases
• Up to 85% of women find they have an improvement within two weeks
Let’s all open our eyes to PeVD
There are three simple steps to follow – these could all make a real difference to the lives of the millions of women who are living with the pain of PeVD.
Consider
• Has she had children?
• Are her symptoms relieved by lying down?
• Are upper leg or vulvo-vaginal varicosities present?
Screen
Request an initial screening using transvaginal sonography, making a specific request for the visualization of varicosities.
Refer
As appropriate to an interventional radiologist or vascular surgeon for treatment with lasting positive effects.
Additional resources
Academy
Visit our educational pages for more detailed information.
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References
1
https://thewhiteleyclinic.co.uk/wp-content/uploads/The-Impact-of-Pelvic-Congestion-Syndrome-Report.pdf
2
https://www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/symptoms-causes/syc-20354368
3
https://www.bsir.org/patients/pelvic-venous-congestion-syndrome/
4
https://www.jvsvenous.org/article/S2213-333X(21)00071-8/fulltext
5
http://www.thewhiteleyclinic.co.uk/conditions/pelvic-congestion-syndrome-pcs/treatment