What are haemorrhoids?

Haemorrhoids are enlarged blood vessels in the rectum and anus, caused by increased pressure in the lower rectum due to straining, pregnancy, chronic constipation, or aging. They can be very painful and common symptoms include pain, itching, and bright red blood on toilet paper. 

How does HAE work?

Haemorrhoid artery embolisation works by reducing the blood flow to the abnormal vessels that cause haemorrhoids. The procedure is performed by an interventional radiologist using image guidance rather than surgery. A small tube (catheter) is inserted, usually through a tiny puncture in the wrist or groin and guided to the arteries supplying the haemorrhoids. These vessels are then blocked using very small particles, coils or glue (or a combination) that reduces the swelling within the haemorrhoid and relieve bleeding and other symptoms.

About the HAE procedure  

Haemorrhoid artery embolisation is typically done under twilight sedation, meaning patients are comfortable but not fully asleep. It usually takes about 45–90 minutes, and most people go home the same day. Because there are no surgical incisions made, pain is generally mild compared to traditional haemorrhoid surgery, and recovery is quicker.

How long does HAE take to work?

Patients often notice improvement in symptoms within days to weeks. Serious complications are very uncommon when performed by experienced interventional radiologists.

How effective is HAE?

Haemorrhoid artery embolisation is a very effective and safe treatment for internal haemorrhoids with success rates of 80%. It is particularly effective for controlling bleeding, especially in grade 1-3 haemorrhoids. Repeat treatment may be required in a small number of cases (20%) if re-bleeding or recurrence is experienced.

Benefits of HAE

HAE has a high success rate and is a minimally invasive outpatient procedure that means you will recover quicker. It also has a low risk of complications and preserves continence.

Is HAE suitable for me?

Haemorrhoid artery embolisation is not suitable for everyone, but it can be a valuable option for patients with ongoing bleeding haemorrhoids who want to avoid surgery or who experience repeat symptoms after surgery. If you think HAE could help you, discuss this technique with your doctor or a specialist to determine whether it is appropriate for you.

Interventional radiology treatment for HAE in Queensland.

Vascular and Interventional Radiology Queensland (VIRQ) is a specialist vascular interventional radiology service comprised of highly skilled and passionate specialists across Brisbane, Sunshine Coast, Ipswich, Toowoomba and Cairns. We provide cutting-edge procedures interventional radiology procedures including haemorrhoid artery embolisation. Speak with your GP or specialist for a referral to learn more about HAE.

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Varicoceles occur when the veins in the scrotum become enlarged due to reversal of blood flow. They are often described as ‘spaghetti’ or a ‘bag of worms’ due to their appearance. They more commonly affect the left side and can cause pain, reduced testicular size and infertility.

How is Varicocele diagnosed?

A doctor can often detect enlarged veins in the scrotum upon examination, however the diagnosis is confirmed through a scrotal ultrasound. If a varicocele is suspected of contributing to infertility, a semen analysis and blood tests may also be recommended.

Varicocele treatment options

There are a number of treatment options available including embolisation or surgery. Varicocele embolisation is a minimally invasive, non-surgical treatment that involves blocking the dysfunctional veins.

What is Varicocele Embolisation?

Varicocele Embolisation is a effective, non-surgical, minimally invasive treatment for symptomatic Varicoceles that involves blocking abnormal veins. Embolisation is most commonly performed to treat painful varicoceles, however, it may also be used as a treatment for infertility.

The procedure can usually be performed as a day case with a mild “twilight” sedation and local anaesthetic, with a more rapid recovery compared to surgery. A needle is inserted into the veins in the neck or groin and the procedure typically takes less than an hour.

Recovery involves some mild pain as the veins “close down” that may last for 1-2 weeks but is typically managed with simple analgesia/anti-inflammatory medications.

Benefits of Varicocele Embolisation

There are numerous benefits of Varicocele Embolisation as a treatment approach, including:

Minimally invasive

Varicocele Embolisation is a non-surgical, minimally invasive procedure. A tiny catheter is inserted into the neck or groin, avoiding the need for a surgical incision in the scrotum.

Success Rate

Embolisation has a success rate of over 95%, meaning it is just as effective as surgical procedures.

Recovery time

Whilst recovery can take 2-3 weeks for surgical procedures, most embolisation patients can return to regular, non-strenuous activities within 24 – 48 hours.

Pain and Symptom Improvement

Over 90% of patients experience relief from scrotal pain and congestion.

Reduced Risk of Complications

As a non-invasive procedure, embolisation avoids risks associated with surgery such as infection of the surgical site, and a does not usually require a general anaesthetic.

In Summary

Varicocele Embolisation is a safe and equally effective alternative to surgical intervention for pain and infertility, but with a faster recovery and fewer risks and side effects.

Queensland Varicocele Embolisation Specialists

Vascular Interventional Radiology Queensland (VIRQ) is a specialist vascular interventional radiology service with leading Queensland Interventional Radiologists. We are highly skilled and passionate specialists experienced in Varicocele Embolisation procedures. Speak with your GP or specialist about a referral to VIRQ to learn more about varicocele embolisation.

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Fibroids are common benign growths within the muscular wall of the uterus. Adenomyosis occurs when tissue similar to the uterine lining grows within the uterine muscle and may contribute to heavy menstrual bleeding, painful periods, pelvic pressure and enlargement of the uterus.

By reducing the blood supply to the affected tissue, UAE can help relieve symptoms over time while avoiding major surgery for many women.

Why consider UAE?

For many women, UAE offers a safe and effective alternative to surgical treatment or removal of the uterus. Potential benefits include a minimally invasive approach, preservation of the uterus, and improvement in symptoms such as heavy menstrual bleeding, pelvic pain, pelvic pressure and bulk-related discomfort. Fertility remains unaffected, and pregnancy remains is possible after UAE.

Recovery is often shorter than with major surgery, although the most appropriate treatment depends on the individual patient, their imaging findings, and their treatment goals.

Although UAE is a well-established treatment internationally, access has historically been more limited for many women in Australia and New Zealand than the evidence would suggest. VIRQ are committed to improving awareness and expanding access to this treatment across communities in Queensland.

How is UAE performed?

UAE is a minimally invasive, non-surgical procedure performed by an interventional radiologist using X-ray guidance. A fine catheter is inserted through a small artery, usually in the groin or wrist, and guided into the uterine arteries. Tiny embolic particles are then delivered to reduce blood flow to the fibroids or areas of adenomyosis being targeted.

The procedure is usually performed with sedation and local anaesthetic, depending on the treatment plan and individual patient factors.

Who may be suitable?

UAE may be suitable for women experiencing troublesome symptoms from fibroids and for some women with adenomyosis. The most appropriate treatment depends on a number of factors, including symptoms; fibroid size, number and location; the pattern and extent of adenomyosis; imaging findings; previous treatment; and whether future pregnancy is a consideration.

A consultation with one of our interventional radiologists can help determine whether UAE is an appropriate option for your individual circumstances. We work closely with your gynaecologist and other members of your care team to ensure treatment is considered in the context of your overall health.

Recovery and important considerations

After UAE, it is common to experience pelvic pain, cramping, tiredness, nausea, or flu-like symptoms for a short period. Recovery is often faster than after major surgery, although each patient’s experience is different.

The expected benefits, limitations and risks of treatment will be discussed carefully during consultation so that the most appropriate management plan can be made for you.

Is UAE right for you?

If you have been diagnosed with fibroids or adenomyosis and are considering treatment, uterine artery embolisation may be worth considering. A consultation with one of our interventional radiologists can help clarify whether this treatment is suitable for you.

Queensland interventional radiology treatment for HAE

Vascular and Interventional Radiology Queensland (VIRQ) is a specialist vascular interventional radiology service comprised of highly skilled and passionate specialists across Brisbane, Sunshine Coast, Ipswich, Toowoomba and Cairns. We provide cutting-edge interventional radiology procedures including haemorrhoid artery embolisation.

Speak with your GP or specialist for a referral to VIRQ to learn more about UAE procedures.

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Pelvic congestion syndrome (PCS) is a common cause of chronic pelvic pain in women. Other terms used for this include pelvic venous congestion and pelvic venous disease.

Blood carried from the ovarian veins usually have valves to allow forward flow of blood towards the heart. These valves may be absent in some women, or may fail, resulting in pooling of blood in pelvic veins, which in turn results in stretching of these veins and raised venous pressure, very much like leg varicose veins you may have seen before.

Diagnosis of Pelvic Congestion Syndrome

Pelvic congestion syndrome can be a difficult diagnosis to make, as pelvic pain in females is often a complex or multi-factorial problem.  It is important to realise that swollen veins in the pelvis found on ultrasound, CT or MRI scans or found at the time of surgery do not always require treatment or cause symptoms.  For this reason, the diagnosis may not be made for some time/require assessment by multiple specialists. While some varicose veins in the pelvis may not cause symptoms, many women who may benefit from embolisation have suffered from pain attributed to other causes or ignored for some time.

Pelvic Congestion Syndrome Pain

Women with PCS often describe pain that is dull, constant, progressively worse throughout the day, worse with prolonged sitting, standing or heavy activity, and relieved with laying down. The pain if often worse during menstruation and can also cause pain during or after intercourse.  However, not all women describe all of these features, and their pain may be of a different quality. There are also other related symptoms that may not be recognised as such by your doctor, such as bladder irritability, lower back, and thigh pain, as well as varicose veins in the leg or vulva.

What is Ovarian Vein Embolisation (OVE) Treatment?

The first line treatment for pelvic congestion syndrome is ovarian vein embolisation. Medical treatment is focused on pain relief and it only temporary. Hormone treatment to suppress ovarian function offers only a few months of relief. Open or laparoscopic surgery (including hysterectomy) is not recommended, as it is less effective and more invasive than embolisation.

Embolisation is a procedure that involves blocking up the dysfunctional veins, thereby eliminating these problematic veins from the circulation, causing the blood to be redirected into properly functioning veins.

Occasionally patients with pelvic congestion syndrome may also have other venous abnormalities such as compression of their common iliac vein (known as May-Thurner anatomy) or left renal vein. Your interventional radiologist can discuss the significance of these with you at the time of your clinic appointment.

Who Performs an OVE?

Ovarian vein embolisation is usually done by an interventional radiologist, an endovascular specialist with extensive training in embolisation.

How does an OVE Procedure work?

An ultrasound is used to guide a tube into the vein at either the base of the neck or groin crease, then a catheter (thin plastic tube) is passed into the ovarian veins under x-ray control. Occasionally, deeper pelvic veins (tributaries of the internal iliac veins) may also need to be treated. The catheter will be passed down this vein into the pelvis where soft metal coils will be placed, with or without liquid sclerosant. Occasionally other agents such as glue can be used.

Is the procedure painful?

The procedure is performed under sedation and local anesthetic, so patients feel no pain during the procedure.

How long does an OVE Procedure take?

The procedure can usually be performed as a day procedure under “twilight” sedation and local anaesthetic through a small incision in the neck or groin, and typically takes about an hour to perform when a full venous assessment is included.  Recovery usually takes 1-2 weeks for the veins to close but can be managed with simple pain killers and anti-inflammatory medications.

What are the side effects of OVE?

Some patients experience mild flank or pelvic discomfort, though this is well managed with medication. You can usually return to your usual activities after a day or so, though it is recommended to avoid heavy lifting or strenuous exercise for 5 -7 days after your procedure.

Risks of OVE

Rare risks of an OVE procedure include coil migration, bruise-related infection, or allergic reactions. However, OVE is generally considered low risk compared to surgery.

Does OVE affect fertility?

There is no data to suggest that OVE affects the menstrual cycle or fertility.

How effective is OVE?

Treatment of pelvic congestion syndrome with embolisation should provide pain relief for most women.

Queensland Ovarian Vein Embolisation Interventional Radiologists

Our team of interventional radiologists at VIRQ are experts in embolisation and have extensive experience treating women with pelvic congestion syndrome.

Vascular and Interventional Radiology Queensland (VIRQ) is a specialist vascular interventional radiology service comprised of highly skilled and passionate specialists across Brisbane, Sunshine Coast, Ipswich, Toowoomba and Cairns. We provide cutting-edge procedures interventional radiology procedures including ovarian vein embolisation. Visit our website to learn more about ovarian vein embolisation or speak with your doctor about a referral to VIRQ for an OVE procedure.

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About BJUI

BJU International (BJUI) is a charity for the advancement and improvement of education in urology and related areas and the diffusion of knowledge of new and improved methods of teaching and practising urology. For almost 100 years BJUI have been publishing cutting-edge urological research and reviews in our flagship journal, BJU International. To this day, the journal remains one of the leading publications for urological research globally.

About the P-EASY Advance study

The P-EASY ADVANCE study was a world-first randomised controlled trial comparing the effectiveness of Prostate Artery Embolisation with standard first-line medical therapy in previously untreated patients. The results of this trial demonstrated that PAE was superior to medications in relieving bladder outflow obstruction, reducing lower urinary tract symptoms and improving quality of life. PAE was also better tolerated and had fewer side-effects than the medication group.

P-EASY ADVANCE is the third study in the “P-EASY” program, which is a world-leading collaboration between interventional radiologists, urologists and researchers at I-MED Radiology and the Wesley Hospital that is expanding treatment options for patients and improving outcomes. 

Read more about the three VIRQ PAE research studies.

What is Prostate Artery Embolisation

Prostate Artery Embolisation is a minimally invasive operation where the arteries to the prostate are blocked off, causing the prostate to reduce in size, and relieve the lower urinary symptoms (LUTS). An enlarged prostate gland can cause many troublesome symptoms such as frequent urination, urgency, hesitancy, incomplete emptying, dribbling, prolonged urinary or intermittent stream. Prostate artery embolisation can relieve these symptoms without the need for a more invasive operation.

VIRQ a leading researcher

VIRQ Interventional Radiologists have a long history of being involved in leading research, and this award is well-deserved recognition for our radiologists and the entire research group at I-MED Radiology and The Wesley Hospital.

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