Embolization for PCS

Typical Therapies for PCS

There are several different methods of treatment for pelvic congestion syndrome or PCS.  The syndrome itself is marked by lower abdominal pain, heaviness and pressure due to the presence of varicose veins in the pelvis brought on most commonly by pregnancy. 

Drugs have proven effective in some cases for treating the pain, depression and anxiety which are associated with PCS. Alternative treatments such as physical therapy, acupuncture and behavior modification counseling have also been successful.  Surgery is used most often as a last resort after all other forms of treatment have failed.  The results of surgery have kept it as a last option and recovery from the surgery can be very prolonged.

Radiological Treatment - Embolization

The last ten years has revealed a new method of treating PCS.  It is a radiological method called embolization and is used only after a diagnosis for pelvic congestion syndrome is confirmed.  Embolization is the act of plugging the blood vessels to prevent them from becoming engorged and after a short time the varicosities will subside.  The procedure takes a few hours and is generally performed by an interventional radiologist.  No anesthesia is required and the patient spends the night in the hospital.  There is a significant amount of pain, nausea and possibly fever during the initial few days following the procedure.

Risks and Results of Embolization

There are risks involved in embolization such as injury to the vessels when the needle is inserted into the groin, possibly causing bruising or bleeding at the puncture site.  The dye used can cause an allergic reaction, so it is wise to advise the doctor of any allergy history.  Occasionally the person does not respond even though the procedure was successful.  Pregnant women should be aware that embolization is associated with exposure to radiation and is probably not suitable for them until after the birth of their baby.

The results of embolization are not conclusive. Despite the reduction in the varicosities, not all women improve.  Less than 60% of women who have undergone this procedure claim to feel better afterward and some women may need multiple sessions.  Pain improvement may take between two to four weeks.  The therapy's success depends largely upon the symptoms and degree of varicosities present at the time of embolization.  Not all women undergoing this procedure have a response to it, and some still continue to have PCS symptoms.

At The End of The Day

The upside of embolization is that it is not surgery, there is no incision and recovery time is not long.  Additionally, there are no risks of complications that are associated with surgery and anesthesia.  There are a greater number of women who appear to benefit from embolization and the relief from the symptoms of PCS can last for years.  From all of the different types of treatments that are recommended, embolization is the preferred therapy.  As with any treatment, reading and becoming informed, as well as talking with your health care provider to understand the condition, help in the decision making process.