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February 19, 2026
Updated February 19, 2026
Varicose veins can recur if pelvic veins ignored
Reflux from pelvic veins can cause leg varicose veins to come back again after treatment
The Whiteley Clinic research has shown why varicose veins come back if pelvic veins are not checked and treated for. The research was published in the Journal of Vascular Surgery (Venous and Lymphatic Disorders) in July 2014.
Background to research
Leg varicose veins are associated with varicose veins hidden in the pelvis (called "pelvic venous reflux") in approximately 20% of women who have had children. Most varicose veins clinics do not routinely check for pelvic venous reflux, nor treat it. The research team investigated a number of female patients with varicose veins that had come back after treatment (recurred). These patients had their open varicose vein surgery elsewhere (not at The Whiteley Clinic). The study team looked to see how many had pelvic venous reflux as a major contributing cause to their recurrence.
About the research study
The study reviewed all patients who had been referred to The Whiteley Clinic in the previous year. The patients had recurrent varicose veins, having previously been treated elsewhere. All patients had a venous duplex ultrasound scan. Those who were found to have reflux of pelvic origin underwent a transvaginal duplex ultrasonography scan. Each case was assessed by a consultant vascular surgeon, and the major cause (or causes) was noted.
The conclusion
The Whiteley Clinic research team identified that pelvic venous reflux is a major contributing cause of recurrent varicose veins after open surgery.
In fact, reflux from the pelvic veins (or hidden pelvic varicose veins) was the second most common cause for patients getting varicose veins back again after surgery.
All patients with varicose veins should have their pelvic veins assessed before varicose vein surgery.
Interesting points
Most doctors and nurses do not know that pelvic venous reflux (Pelvic varicose veins) can cause leg varicose veins. The failure of doctors to look for and treat pelvic vein reflux is a major reason that varicose veins recur after surgery in women.
Benefits to The Whiteley Clinic patients
All patients with leg varicose veins have a duplex scan of their veins using one of our specialist vascular technologists using the Whiteley Protocol.
Any female with venous reflux coming from the pelvis is offered a transvaginal duplex ultrasound scan. This specialist scan was developed at The Whiteley Clinic to show the pelvic veins. It shows which veins are causing the pelvic vein reflux so they can be treated. The availability of this scan is one of the many reasons that the recurrence rates at The Whiteley Clinic are so low.
About the research team
The team consisted of Alice Whiteley and Daniel Taylor (both Summer Research Fellows at The Whiteley Clinic during 2013), Scott dos Santos (Research Co-ordinator) and Professor Mark Whiteley. The results of the study were presented at :
- The American Venous Forum 2013 Annual Meeting
- 10th International Symposium on Endovascular Therapeutics
- 14th Meeting of the European Venous Forum
For more information on our published research or prize winning research, please see our website. Alternatively, if you want more information you can contact us using the contact form, email at [email protected] or call us on 01483 477180.
