Pelvic vein embolisation

What is pelvic vein embolisation?

Pelvic vein embolisation is a keyhole (minimally invasive) procedure used to treat pelvic congestion, also called pelvic venous disorder. This is where veins around the womb and ovaries become enlarged and do not drain properly, which can cause a dull, dragging pelvic pain or heaviness that is often worse on standing, before periods or after sex.

An interventional radiologist passes a thin tube (catheter) into a vein, usually through the groin or neck, and guides it using X-ray pictures to the faulty pelvic veins. Tiny metal coils, and sometimes a foam, are placed to block these veins. Blood then reroutes through healthier veins, and the treated veins shrink over the following weeks.

It is important to be clear that pelvic pain has many causes. Embolisation only helps pain that is genuinely coming from these veins, so a careful assessment first is essential. It is not a treatment for period pain, endometriosis or other gynaecological conditions on their own.

The procedure is usually well tolerated, but it does not work for everyone, symptoms can return, and there are risks to weigh up.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your procedure

• Have a proper assessment first, including scans, so other causes of pelvic pain are considered before treatment.
• Tell the team if you are or might be pregnant, as this procedure uses X-rays and is not done in pregnancy.
• Mention any allergy to X-ray contrast dye, and any kidney problems, as contrast is used.
• List all your medicines, especially blood thinners, and ask whether any need adjusting beforehand.
• Ask whether you will have sedation, and if so arrange someone to take you home and stay with you.
• Plan a few quiet days afterwards, as cramping pelvic pain is common in the first days.
• Ask what realistic improvement to expect and how likely symptoms are to return.

What happens

The procedure is done in an X-ray (interventional radiology) suite, usually under local anaesthetic and sometimes with sedation. You lie on a table and the skin over a vein in your groin or neck is numbed.

A thin catheter is passed into the vein and guided to the faulty pelvic veins using X-ray pictures and a small amount of contrast dye. Once the veins are mapped, the radiologist places tiny coils and sometimes a foam to block them. You may feel pushing or mild cramping but should not feel sharp pain.

The catheter is removed and pressure is applied to the small entry point; stitches are not usually needed. The procedure often takes about an hour. Most people rest for a short time and go home the same day.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The biggest uncertainties are whether your pain is truly coming from these veins and how much it will improve, since pelvic pain often has more than one cause. Coil migration and clots are uncommon but recognised. Ask how confident the team is about the diagnosis, what improvement is realistic, and what the plan is if symptoms persist or come back.

Published figures to discuss

Reported pain relief varies widely between studies and depends heavily on how carefully patients are selected and how 'success' is measured. Because pelvic pain often has more than one cause, results are difficult to compare and an exact single success figure is not reliable. Complications such as coil migration are uncommon but recognised, and rates differ by technique and team.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Recovery is usually quick, but it is normal to have cramping pelvic pain for a few days as the treated veins close down. Improvement in your original symptoms tends to build up over several weeks.

• Cramping or aching pelvic pain for a few days
• Mild bruising or tenderness at the groin or neck entry point
• Feeling a little tired for a day or two
• Gradual rather than instant improvement in the original symptoms
• No external wound to care for, just a small entry point

Aftercare

• Use simple painkillers as advised for cramping pelvic pain in the first days.
• Keep the entry-point area clean and dry, and watch for redness, swelling or discharge.
• Avoid heavy lifting and strenuous exercise for the first few days, then build back up.
• Do not drive for 24 hours if you had sedation, and follow any specific advice given.
• Stay reasonably active and hydrated to lower the small risk of a clot.
• Keep your follow-up appointment so your response to treatment can be reviewed.
• Contact the team if pain is severe, you develop a fever, or the entry point bleeds or swells.

• Simple painkillers at home for cramping
• Someone to drive you home if you had sedation
• A few quiet days planned around the procedure
• Clinic out-of-hours contact number saved
• Follow-up appointment booked
• List of warning signs to watch for

Scars and how they heal

There is no surgical cut. Access is through a small needle puncture in a vein in the groin or neck, which usually leaves only a tiny mark and may bruise for a week or two. Stitches are not normally needed.

⚠ Get urgent help if…

• Severe or worsening pelvic or tummy pain that painkillers do not control
• A high temperature, shivering or feeling generally unwell (possible infection)
• Bleeding, increasing swelling or a spreading bruise at the entry point
• A hot, swollen, painful leg, which could suggest a clot
• Sudden breathlessness or chest pain — call 999
• A rash, swelling or difficulty breathing soon after the procedure (possible contrast reaction)

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result means a meaningful reduction in the dragging pelvic pain and heaviness over the weeks after treatment. Many people notice useful improvement, although the degree varies and some have only partial relief.

Embolisation cannot promise complete or permanent freedom from symptoms, and it does not treat other causes of pelvic pain. If your pain has more than one source, treating the veins may only address part of it. This is why an honest discussion about the likely cause and realistic improvement matters before you proceed.

For many people the benefit lasts, because the treated veins are permanently sealed and shrink away. However, new faulty veins can develop or other pelvic veins can contribute over time, so symptoms occasionally return and a further procedure is sometimes considered. Ongoing pelvic pain should always be reassessed rather than assumed to be the same problem.

Related tests, treatments or support

Embolisation is sometimes combined with treatment of related varicose veins, including vulval or leg veins that are linked to the pelvic veins. It may also be one part of a wider plan if you have more than one cause of pelvic pain, alongside gynaecological assessment where appropriate.

Follow-up & long-term care

You will usually be reviewed several weeks to a few months after the procedure to assess how your symptoms have responded. If improvement is only partial, the team may discuss treating additional veins or looking again for other causes of pain. Any severe pain, fever or leg swelling should be reported straight away rather than waiting for the appointment.

Repeat, follow-on and what comes next

• Some people need a further procedure to treat additional veins if symptoms only partly improve.
• Symptoms can return over time if new faulty veins develop.
• Coil migration is uncommon but may rarely need a further procedure.
• Ongoing pain should be reassessed rather than assumed to be the same problem.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Clear written advice on the cramping pain to expect and how to manage it.
• A named contact and out-of-hours number for problems.
• A planned follow-up to review your symptom response.
• A clear plan for reassessment if symptoms persist or return.
• Honest discussion of whether further treatment may be needed.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The scans and assessment needed to confirm the diagnosis beforehand
• The interventional radiologist's fee
• The X-ray suite and facility costs
• The number of veins treated and the coils or foam used
• Sedation, if used, and the staff involved
• Follow-up appointments and any repeat imaging
• Treatment of any complications or the need for a further procedure

• The cost of the assessment and scans needed first
• The radiologist's procedure fee and the facility fee
• What coils, foam and contrast are included
• Whether sedation is included if you need it
• Follow-up appointments and any repeat imaging
• What happens, and what it costs, if symptoms persist or a further procedure is needed
• What happens if a complication occurs

On the NHS? Pelvic vein embolisation is available on the NHS in some areas when criteria are met, but access varies by region, so some people are treated privately for speed or choice.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the surgeon is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the surgeon who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• How confident are you that my pain is coming from these veins rather than another cause?
• What realistic improvement should I expect, and how likely are symptoms to return?
• Will you use coils, foam, or both, and which veins do you plan to treat?
• What are my chances of needing a further procedure?
• What pain should I expect afterwards, and how should I manage it?
• What is the plan if my symptoms do not improve?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for pelvic vein embolisation

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: University Hospital Southampton — Pelvic vein embolisation (PDF) Worcestershire Acute Hospitals NHS Trust — Ovarian vein embolisation PMC — Embolisation approach to pelvic congestion syndrome NICE — Venous thromboembolic diseases (NG158)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.