EMBOLIZATION FOR PELVIC CONGESTION SYNDROME

What is pelvic congestion syndrome:

• Pelvic congestion syndrome is defined as chronic pelvic pain in women due to incompetent (dilated and refluxing) pelvic veins.

What are the symptoms of pelvic congestion syndrome:

• It is responsible for chronic pelvic pain in 30 % cases of multiparous (multiple pregnancy) women.
• Dragging sensation or pain in the pelvis.
• Feeling of fullness in the legs.
• Worsening of stress incontinence.

How it can be treated:

• Percutaneous transcatheter pelvic vein embolisation is the treatment of choice. 
• Other treatment options are open or laparoscopic surgery to tie the culprit veins. Both these procedures are more invasive than ovarian vein embolisation and require a general anaesthetic and a longer recovery period.
• Pelvic vein embolisation is a minimally invasive procedure performed by a specially trained interventional radiologist in the interventional radiology suite.
• Using x-ray image guidance and contrast material to see the blood vessels, the catheter is then directed into abnormal ovarian and/or pelvic vein. Abnormal vein is sealed and blocked using synthetic material or medication called embolic agents.

What are the benefits:

• Pelvic vein/ovarian vein embolisation has been shown to be a safe and effective procedure with relief of the symptoms of pain.
• No surgical incision is needed—only a small nick in the skin that does not have to be stitched closed.
• Fewer complications and the hospital stay is relatively brief – typically this is done as a day case.

Preparation for the procedure:

• Few basic blood investigations like CBC, PT/INR, viral markers.
• Fasting for 4-6 hrs.
• Bring all the records including imaging record.
• Signing consent form.

What are the risks:

• Pain, bleeding, non-target embolization, infection (<1 case in 1000).