Women's Health
Pelvic Congestion Syndrome (PCS) • Uterine Fibroid Embolization (UFE)
Uterine Fibroids
Uterine fibroids are benign tumors that grow in the wall of the uterus. They are very common, affecting up to 70-80% of women by age 50. Women experiencing symptoms from their uterine fibroids experience excessive pain and may also have heavy menstrual bleeding that lasts longer than average. Other symptoms may include pain with intercourse, urinary frequency, and bloating. Fibroids can range in size from small (the size of an apple seed) to quite large (the size of a grapefruit). In rare cases, fibroids can grow so large they can cause complications with the bladder and rectum.
Treatments
Uterine Fibroid Embolization (UFE “YOU-fee”) is a highly effective way of treating uterine fibroids which does not involve invasive surgery. The procedure is performed by an interventional radiologist. Through a pinhole incision in the groin or wrist, a very small flexible hollow tube (catheter) is precisely placed into the specific arteries that supply the uterus under x-ray guidance. Tiny microspheres are injected through the catheter to permanently block the blood vessels of the fibroids. Thus deprived of blood, the fibroid tissue dies, the fibroids shrink over time, and in almost all cases the symptoms are improved or resolved completely. UFE, performed under IV sedation at our center, is a minimally invasive procedure and does not involve surgically removing the uterus or any part of the uterus. Only intravenous sedation is needed during the procedure (no general anesthesia is required). Patients typically go home just a few short hours after their UFE procedure, and have a much quicker recovery than surgery.
Venous Embolization for Pelvic Congestion Syndrome is a non-surgical, minimally-invasive procedure where a small incision is made in the neck or in the groin. A very small flexible hollow tube (catheter) is advanced through this incision and directed into the abnormal veins under x-ray guidance. The abnormal vein is then permanently blocked using metal coils, plugs, or a special glue, all of which are delivered through this tiny catheter. The procedure is performed in our office and patients go home only a few hours after the procedure. Only intravenous sedation is needed during the procedure (no general anesthesia is required). There is a very short recovery time with most patients going back to normal activities within just a few days.
Pelvic Congestion Syndrome (PCS)
Pelvic Congestion Syndrome (PCS)—also known as Pelvic Venous Insufficiency—can be an unrecognized cause of chronic pelvic pain in women. Chronic pelvic pain is defined as pelvic pain that is not related to the menstrual cycle, and is present for greater than six months. In 75% of women, no definite cause for their chronic pelvic pain is found.
PCS, like varicose veins, is caused by valves in blood vessels that don’t work properly. This causes dilatation of the ovarian veins and other veins draining the pelvis.
Some women (6-15%) naturally have no valves or have incompetent valves. During pregnancy, ovarian blood flow increases up to 60 times, resulting in valve damage. Incompetence allows backwards flow of blood causing varicose veins in the pelvis. The varices put pressure on the structures of the pelvis leading to the symptoms.
- Usually younger women between ages 20 and 40, but can occur at any age
- More common in women who have had multiple pregnancies
- 90% of women with unexplained chronic pelvic pain have dilated pelvic veins and venous congestion
- Chronic (longstanding) abdominal or pelvic pain, sometimes back pain.
- Usually worse after prolonged standing, after sexual intercourse, during menstruation, and after exercising. Symptoms are often improved by lying down.
- May be associated with varicose veins in the thigh, legs, buttocks or vaginal area.
- Other symptoms include fatigue, bladder irritation or urgency, pelvic or abdominal fullness or pressure.
- Chronic (longstanding) abdominal or pelvic pain, sometimes back pain.
- Usually worse after prolonged standing, after sexual intercourse, during menstruation, fatigue, and after exercising. Symptoms are often improved by lying down.
- May be associated with varicose veins in the thigh, legs, buttocks or vaginal area.
- Other symptoms include bladder irritation or urgency, pelvic or abdominal fullness or pressure.
