Pelvic Congestion Treatment
If you’re experiencing pelvic pain and require treatment, you may have pelvic congestion syndrome. Sydney Fibroid Clinic offers ovarian vein embolisation to treat symptoms of pelvic congestion syndrome.
Ovarian Vein Embolisation for Pelvic Congestion
Ovarian vein embolisation (OVE) is the treatment of choice for pelvic congestion syndrome.
The treatment targets the root cause of pelvic venous congestion: ovarian vein reflux. The embolisation procedure blocks the refluxing ovarian vein to stop unnecessary venous backflow down the pelvis, thereby relieving the symptoms caused by congestion.
The procedure and its benefits can be summarised as follows:
- Local anaesthetic procedure
- Minimally invasive, safe and effective
- 83% patient satisfaction rate
- No surgical cuts, no general anaesthetic
- No down time, back to normal activities next day
The local anesthetic procedure is performed by an interventional radiologist in an angiography suite, as a day procedure. A light sedation is given, and the skin entry site is numbed with local anaesthetic. Either the jugular or femoral vein is used for entry into the vein.
During the process, a tiny nick is made in the skin for a catheter (a small plastic tube) to be inserted. The catheter is navigated inside the vein under X-ray guidance. A venogram is performed by injecting X-ray dye to show the veins and direction of blood flow. Once reflux is confirmed, stainless steel or platinum coils are fed through the catheter to the block the vein. A sclerosing agent is injected to secure long-term blockage of the refluxing veins.
The procedure takes about an hour, but it can be longer if additional refluxing veins are found and need to be treated.
Post-procedure, patients require bed rest for 1 – 2 hours until the sedation wears off and will need to arrange transport, as driving is not allowed for 24 hours after sedation. Patients should take it easy at home, drink plenty of fluid and can resume normal activities the following day – though strenuous exercise should be avoided initially. The dressing should be kept for two days and removed afterwards. Some patients may experience back and pelvic pain for 1 – 2 days after embolisation, though this can be controlled with Panadol and Nurofen. Follow-up with Dr Liang is scheduled one month after the procedure.
For more information on OVE as a pelvic congestion syndrome treatment, make an enquiry with Sydney Fibroid Clinic.
Laparoscopic Ligation for Pelvic Congestion
Laparoscopic ligation is a surgical procedure in which a woman’s ovarian veins are tied off. Though tying off the ovarian vein is effective in 80% of patients with pelvic congestion syndrome, it is a much more difficult and invasive procedure than ovarian vein embolisation. This surgical procedure is not more effective than Ovarian Vein Embolisation (OVE) and therefore it is rarely performed.
Hysterectomy for Pelvic Congestion
It is important to note that pelvic congestion syndrome is a venous problem and not a problem of the uterus. Therefore, it does not make sense to remove the uterus.
A hysterectomy for pelvic congestion syndrome is ineffective in a large percentage of patients. Immediately following hysterectomy, pain is still present in in 33% of patients. Recurrence of pelvic pain is noted in 20% of patients. Hysterectomy therefore should not be a treatment for pelvic congestion syndrome.
The cause of pelvic congestion syndrome is the refluxing ovarian vein, which can be effectively blocked non-surgically by ovarian vein embolisation.