Ovarian Embolisation Patient information leaflet (188kB pdf)
Introduction
We hope this guide will answer your questions about your ovarian embolisation procedure. Please contact the team if you require further information via the details at the end of this leaflet.
What is an ovarian embolisation?
Ovarian vein embolisation is a minimally invasive procedure used to treat pelvic congestion syndrome (PCS). PCS occurs when blood collects in the veins of the pelvis, which can cause pain, discomfort, and other symptoms. The procedure involves the insertion of a catheter (small plastic tube) into a vein in the neck or groin which is guided to the affected ovarian vein using x-ray and contrast medium (an iodine based solution otherwise known as X-ray dye). This is followed by injection of a substance (usually a type of coil or foam) that causes the affected vein to become blocked, reducing blood flow and relieving symptoms.
Why do I need an ovarian embolisation?
Your doctor has recommended that you have pelvic vein embolisation because your recent test and/or scan results show that your symptoms are being caused by pelvic vein congestion. Your symptoms may include:
- Chronic pain around your pelvis and lower tummy
- a feeling of heaviness in your pelvis
- painful sexual intercourse
After a discussion with an interventional radiologist (a specialist doctor who performs embolisation procedures), your doctor believes pelvic vein embolisation is the best treatment option for you.
What are the benefits?
Multiple studies have shown that most women (80%) experience a reduction in symptoms after having pelvic vein embolisation.
Are there any alternatives?
If you decide that you do not want pelvic vein embolisation, your doctor will be happy to discuss the alternative treatment options with you and explain the benefits and risks of each, so that you can make an informed decision.
What are the associated risks?
X-Ray radiation: All x-ray procedures involve exposure to radiation in varying amounts. The dose you get from a medical x-ray is very low and your doctor along with the radiologists have determined that the benefits of having the examination outweigh potential risks. The radiographer is present throughout your test making sure that the radiation dose is kept as low as reasonably possible and the duration and level of x-rays are kept to a minimum.
Contrast medium: A very small number of patients have an allergic reaction to the contrast medium (x-ray dye). This can be minor, severe, or even life threatening but the chances of this occurring are very rare. If you get an itchy rash or difficulty breathing during the procedure tell a member of staff, the team will provide appropriate treatment. Before your examination begins the radiographer will ask you a series of questions about your medical history, including any allergies you may have. This will help us assess if you are at risk of an allergic reaction to the x-ray dye.
The Procedure: Ovarian vein embolization is a very safe and relatively quick procedure, intended to reduce the pain/discomfort associated with PCS, and to prevent you from having a more invasive operation. There may be some bleeding and bruising around or from the insertion site in your neck or groin, the insertion site will be determined by the radiologist dependent on the most suitable vein. There is a small risk of infection at the procedure site. There is a chance that the problem will reoccur. If this happens, the procedure may need to be repeated, or your gynaecologist may have to explore other options for treatment.
Patients aged 12 to 55, could you be pregnant? X-rays can be harmful to an unborn
baby and should be avoided by patients who are or may be pregnant. It is recommended that the examination is performed within 10 days of the first day of your menstrual period. If your appointment is not within this time or if you think you may be pregnant, please contact the X-ray department before your appointment. When you arrive for your Angioplasty, you will be asked when your last period started. If it is more than 10 days earlier, your appointment may be postponed.
Breastfeeding: : During the procedure, you will be given an injection of contrast medium. These agents are low risk contrast agents. A very small percentage of the injected contrast enters the breast milk but virtually none is absorbed across the gut of the infant. No special precautions are required and you can carry on breastfeeding as normal. However, if you have any concerns you may want to express some breast milk prior to your appointment. This information is from guidance provided by The Royal College of Radiologists.
Preparing for your procedure
You may be asked not to eat for four hours before the procedure, although you may still drink clear fluids such as water. Please continue to take any medication that can be taken without food. If you are an insulin-dependent diabetic, do not take your insulin in the morning; please bring it with you to the hospital. It is also advisable to arrange to have someone at home with you for the first 24 hours after the procedure. Please leave any jewellery or valuables at home. Please contact the booking team before your appointment if:
- you are or think you may be pregnant
- you have had a previous allergic reaction to contrast medium (X-ray dye) or are allergic to iodine.
- you are a diabetic taking Metformin.
- you weigh over 30 stone/190 kilograms
- you plan on using hospital transport or need a hoist to transfer
- you require an interpreter – please inform us as soon as you receive your appointment letter, and we will arrange an interpreter for you
If you are unsure or have questions about your preparation, contact your doctor or the X-ray department for advice.
Allergies
If you have any allergies, you must inform your doctor. If you have previously reacted to contrast medium (X-ray dye) you must tell your doctor about this.
Medication
Please contact the radiology department if you are taking blood thinning medication (anti coagulants) such as Warfarin, Aspirin, Rivaroxaban, Dabigatran, Apixaban, Edoxaban or Clopidogrel, Ticagrelor. You may be asked to stop or be given alternative medication.
Getting to us
Once you have arrived at The Princess Alexandra Hospital (Hamstel Road, Harlow, Essex,
CM20 1QX), follow the signage to the radiology reception, which is located on the ground floor, green zone. Please let the radiology receptionist know that you have arrived for your appointment.
When should I arrive?
Please arrive in the radiology department at your given appointment time. A notification
through text or letter should have been sent to you to confirm this appointment.
Can someone stay with me in hospital?
You may have a friend or relative attend with you, but they will be asked to stay in
the waiting area while you have your procedure.
Children are not allowed in the waiting area unattended. Our staff are not permitted to
supervise children, so please ensure child care arrangements are in place to avoid your
tests being rescheduled.
The day of the procedure
You will be shown to a cubicle and asked to undress and put on a gown; please bring a dressing gown if you have one. You may also be asked to remove jewellery, dentures, glasses, or other metal objects, which may show up on the X-rays.
The procedure
Your identification will be checked by a nurse and radiographer, a brief history will be taken; please tell the radiologist what medication, severe allergies, choking episodes or other medical conditions, such as thyroid disease and diabetes you may have. Before the procedure, the interventional radiologist will explain the procedure and ask you to sign a consent form. Please feel free to ask any questions that you may have and, remember that even at this stage, you can decide against going ahead with the procedure if you so wish. You will then be taken into the X-ray room where you will be asked to lie down on the X-ray table. The nurse will paint the groin or neck area with cold antiseptic skin preparation and cover the groin or neck area with blue sterile towels to keep the area clean. We will also be taking your blood pressure and pulse at intervals throughout the procedure. A small injection of local anaesthetic will be given in the chosen area; this will sting at first and then go numb. A small tube is then passed into the vein in your neck or groin via a small needle and wire. You may feel some pushing at this stage, but it should not be painful; if it is then we can help by giving you more local anaesthetic. Once the tube is in position an injection of contrast/dye via the tube will be given to highlight the veins. You may feel a warm sensation in the groin area; this is normal. The images will identify the area to be embolized, and once this is located the radiologist will pass the coils through the tube to block the vein. A liquid is also injected into the veins to help the blockage, which can cause some discomfort.
How long will this take?
The procedure usually takes about 45 minutes but can take longer in some cases.
Is it uncomfortable?
This procedure is not painful but, it can be uncomfortable and unpleasant.
After the procedure
Nursing staff will carry out routine observations such as taking your pulse and blood pressure to make sure there are no problems. They will also check the wound site to make sure there is no bleeding. You will be kept in the department for about an hour. You can eat and drink normally.
Can I drive after my procedure?
We recommend that you do not drive for twenty-four hours and you ask a friend or relative to drive you home following your procedure.
How soon can I return to work?
This will depend on the individual, but most patients recover within one week. However, we recommend that you avoid heavy lifting and strenuous exercise for the first 48 hours after your procedure.
What do I do if I feel unwell after I have gone home?
You may have a small amount of bruising around the site of entry; however, if you notice any excessive bleeding you should call your GP, or go straight to the A&E department. If you experience a high temperature or fever, excessive pain, or diarrhoea you must contact your GP or the A&E department as you may have an infection which needs to be treated with antibiotics.
Follow up
We will arrange an ultrasound scan (a procedure that uses high-frequency sound waves to create an image of part of the inside of the body) and a follow-up clinic appointment with the interventional radiologist two months after your procedure.
Contacting the team
- If you have any further questions about your procedure or an existing appointment, please contact the radiology department (Monday to Friday, 9am to 4pm) at 01279 82 2527 or 3405
- If you have any queries outside of working hours (after 4pm and on weekends), you will be redirected to the main radiology reception. Please note appointment bookings cannot be made during this time.
Your feedback matters
- If you would like to give feedback on your care, please contact our patient experience team at [email protected] or01279 827211.
- Please contact the communications team at [email protected] if you would like this leaflet in another language or format.