How to make the Diagnosis of Pelvic Veins Reflux:

Firstly, and most obviously, the diagnoses of Vulval varicose veins and Vaginal varicose veins is made by simple examination - indeed, most women with these conditions tell us that they have them!!

However, what we are really talking about here is the underlying cause of the vulval varicose veins, vaginal varicose veins or leg varicose veins coming from the pelvis.

Where the Varicose Veins Arise:

The first way to diagnose this problem is by simply looking.

Usually there is a history of Vulval Varicose veins in pregnancy. Looking at the top of the thigh, there is a Tendon called the Adductor Longus tendon (see diagram on the right).

This can be easily felt in everyone - it feels hard and like a tube to the touch.

If the veins arise in front of this tendon, then they almost always come from the veins in the legs - these are NORMAL varicose veins (see www.veins.co.uk for more information about these).

If the veins arise behind this tendon (see picture on right), on the inside of the thigh - or running down the back of the leg, then they are almost always coming from Ovarian or Pelvic veins reflux.

These veins CANNOT be treated by traditional methods of varicose vein surgery.

Trans-vaginal Duplex Ultrasound (TVS)

When ovarian or pelvic vein reflux is suspected, or vulval varicose veins have been seen, or when varicose veins appear in the legs behind the Adductor Longus tendon, a specialised Ultrasound examination is required.

The veins in the pelvis cannot be seen easily by ultrasound across the abdomen - as they are too deep.

Therefore we use a special ultrasound probe that can see the veins though the vagina.

Our specialist female vascular technologists perform this test and can check if there are varicose veins in the pelvis - and if there are - where they are coming from.

Although most do come from the ovarian veins (as described before) there are other veins in the female pelvis that can also cause the same thing - the internal iliac veins.

The technologists can show the patient what is going on as they have the scan - and then they write a detailed report so that the consultants can try to plan appropriate treatment.