Vein embolization for pelvic congestion syndrome in women
The procedure is also known as the PCS embolization – occluding dilated veins in the pelvis
Why would you need the intervention?
Dilated veins in the pelvis and around the uterus are caused by valvular diseases of the ovarian and pelvic veins. A lot of blood returns and remains in the pelvic veins so they pronouncedly expand. A female patient starts experiencing discomforts when the uterine veins reach a high degree of dilatation. The most common discomfort is the pain which lasts over 6 months and which cannot be associated with other causes. Other symptoms and signs are dilated veins on the skin of the genital area, in the groin (inguinal area) and on the legs. A pain in the legs occurs rarely, as a result of a pressure on the pelvic nerves, caused by dilated veins. All previously described problems indicate the intervention.
When would you need the intervention?
Embolization is indicated in female patients diagnosed with the dilation of the uterine veins and significant dilatation of the ovarian vein, verified by the color flow Doppler ultrasound examination of the abdomen and pelvis or abdominal and pelvic MRI venography, and in female patients who have clear symptoms including chronic pelvic pains and dilated veins on the skin of the genital area and legs.
Which radiological examination is required before indicating an intervention?
Magnetic resonance – Abdominal and pelvic MRI venography
What does the intervention include?
Pelvic vein embolization is performed under local anesthesia and a patient is sedated. The intervention starts with a small needle stick in the inguinal vein. A thin catheter is threaded to the targeted dilated pelvic vein. Various embolization materials are applied to achieve blockage of the blood flow in order to exclude the vein from the venous circulation. The intervention is performed though one insertion. All dilated pelvic veins are embolized. The duration of the intervention is usually around 60-90 minutes. The intervention ends by pressuring the catheter insertion site with hands or by using an additional agent to close the insertion site.
Should a patient expect some discomforts during and after the intervention?
The only discomfort is usually a mild pain or discomfort in the pelvis a few days after the intervention. A slightly higher body temperature occurs very rarely.
A patient can return to his daily routine 24 to 48 hours after the embolization performed.
What result should a patient expect from the intervention?
After the uterine vein embolization, a patient can expect significant improvements including the pelvic pain and pressure relief. Dilated veins on the skin of the genital area and legs can party or completely disappear as the result of the dilated pelvic vein occlusion.
How to get prepared?
A patient is to come on an empty stomach and shall not smoke before the intervention (for at least 6 hours). A patient should have his groins shaved.
Related tests and examinations:
A patient should bring laboratory test results (creatinine blood and prothrombin time are obligatory).