The results of the experience with the treatment of small pelvis varicose veins gained during the 11 year-long period were analysed for the elucidation of the causes of relapses of the disease following a variety of surgical interventions on the gonadal veins. The reappearance of the symptoms of small pelvis varicosis after the surgical treatment was documented in 9.3% of the patients. They were attributable either to the insufficiently thorough examination of pelvic veins (that failed to reveal the multi-trunk type of gonadal vein structure or compression of the left common iliac vein) or to the intraoperative technical errors (cranial localization of embolization coils in the vein, reduction of the blood flow velocity in one or several trunks of the gonadal vein). The authors have developed an algorithm for the examination and treatment of the patients suffering relapses of chronic pelvic pain following surgical interventions on the gonadal veins taking into consideration the possibility of pathological changes in their renal and iliac venous segments. The optimal surgical strategy is recommended.