Mark Whiteley
Although virtually everybody has heard of varicose veins in the legs, very few people understand pelvic varicose veins. This project is aimed at understanding pelvic varicose veins and finding the best treatments for the condition.
Pelvic varicose veins cause two main problems, "pelvic congestion syndrome" or chronic pelvic pain, and varicose veins of the legs and intimate areas. Millions of women suffer needlessly from chronic pelvic pain, because so few doctors understand or look for pelvic varicose veins. Many doctors treating leg varicose veins do not consider pelvic veins as a cause. It is because they ignore the pelvic varicose veins that so many people think that "varicose veins always come back".
I got interested in pelvic congestion syndrome and pelvic varicose veins in 2000, when a patient came to me with recurrent varicose veins. She had seen several famous doctors in London and had undergone many varicose vein operations, all of which had failed.
When I examined her, it was clear that the varicose veins were not coming from her legs, but were emerging from her pelvis next to her vulva and vagina. Further investigation showed us that she had pelvic varicose veins causing her leg varicose veins.
As a doctor, I already knew that men could get varicose veins around the testicles. It turns out women get varicose veins and their ovaries, but doctors ignore this as they are deep inside.
As our research continued, we found many worry statistics such as: - 1 in 6 women with leg varicose veins have them arising from the pelvis, but most doctors treating varicose veins never check for pelvic varicose veins! - 1 in 30 men have the same problem, and until we recently published this nobody ever checked men with leg varicose veins for pelvic varicose veins. - One in three (30%) of women with chronic pelvic pain have this due to pelvic varicose veins (or "pelvic congestion syndrome") but are usually told that there is nothing wrong with them or they have "endometriosis".
So whether we are talking about the millions of women (and also a great number of men) who have pelvic pain or other public symptoms due to varicose veins, or the millions of women and men who have leg varicose vein treatments which will fail because the doctor treating them did not check the pelvic veins, it is clear that this is a major area of healthcare that is frequently overlooked.
The Whiteley Clinic
Practitioner briefing
Remember to consider the diagnosis of pelvic congestion syndrome when assessing patients with pelvic pain or discomfort and no other obvious cause. It is often missed on CT, MRI or venography - the patients need the Transvaginal Duplex Ultrasound scan using the Holdstock-Harrison Protocol.
Practitioner briefing
30% of women with chronic pelvic pain have pelvic congestion syndrome (pelvic varicose veins). Do not forget this diagnosis when other tests for endometriosis, ovarian cysts and other causes of pelvic pain are negative. It is often missed on CT, MRI or venography - the patients need the Transvaginal Duplex Ultrasound scan using the Holdstock-Harrison Protocol.
Press briefing
https://www.express.co.uk/life-style/health/680018/varicose-veins-suffer-skin-treatment-intimate-places
Press briefing
https://www.express.co.uk/life-style/health/776122/pelvic-congestion-syndrome-symptoms-pain
Press briefing
A report in the Mirror https://www.mirror.co.uk/news/uk-news/womans-vagina-veins-removed-after-22520620
Press briefing
https://www.dailymail.co.uk/femail/article-8616107/Woman-34-veins-vagina-removed-without-pain-relief-sex-left-chronic-pain.html
Press briefing
Publication quoting our research in the telegraph https://www.telegraph.co.uk/beauty/body/could-hidden-syndrome-causing-varicose-veins/
Our paper explaining anatomical abnormalities we have found when performing pelvic vein embolisation
In this letter, we showed the error that was made in this paper, which suggested leg varicose veins were not often associated with pelvic varicose veins.
A description of the Nutcracker syndrome, May Thurner syndrome and how they relate to pelvic congestion syndrome from 2016.
This abstract of our presentation at the American Venous Forum showed that failure to treat pelvic veins led to recurrent varicose veins in 25% of women
Leg varicose veins are associated with pelvic venous reflux in approximately 20% of women who have had children.
This groundbreaking study showed that measuring the size of pelvic veins on CT, MRI or venography is useless to diagnose pelvic congestion syndrome
This research showed that the best way to diagnose pelvic congestion syndrome is by transvaginal duplex ultrasound using the Holdstock-Harrison protocol
This was the first paper to measure the long term results from the treatment of pelvic congestion syndrome using metal coil embolisation.
This was the first published paper linking hip pain with pelvic congestion syndrome 2 patients with hip pain were cured by treating their pelvic varicose veins
This was the first research paper to show that it was safe to go through pregnancy after having had treatment for pelvic congestion syndrome with metal coils
This was a very interesting case where a woman developed suprapubic varicose veins during pregnancy, having previously had coil embolisation for PCS
In this opinion piece, Prof Mark Whiteley explained the need for an objective measurement of pelvic vein reflux to assess severity of pelvic congestion syndrome
This was the first research paper showing the link between leg varicose veins and pelvic varicose veins in males. It helps understand male PCS.
In this paper we described how pelvic vein embolisation can be performed safely under local anaesthetic as a walk in-walk out procedure
Due to his work in the understanding of pelvic congestion syndrome, Prof Mark Whiteley was invited onto the UIP consensus panel for this document.
Pelvic congestion syndrome explained by Prof Mark Whiteley in 2015. However, things have already moved on since this simple explanation!
The first book available describing pelvic congestion syndrome and the link with pelvic varicose veins - how it is diagnosed and treated
