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I think I may have PCS. What are the best treatment options for this?
The treatment for pelvic congestion syndrome is highly individualized and must be planned with detailed information from the clinical history and examination, color duplex imaging of the abdominal and pelvic veins, and CT or MRI of the abdominal and pelvic veins. Finally, venograms (X-ray imaging of veins after injection of an X-ray contrast agent into the veins) and intravascular ultrasound (ultrasound imaging of the veins by means of a small tube inside the veins) often provide critical information to make decisions regarding treatment.
Treatment may involve closing veins of the pelvis by injecting a foam sclerosant or a small metal coil to cause the veins to seal shut. This usually is done by a needle stick technique to introduce a catheter through the femoral vein at the groin or by the jugular vein in the neck. Sometimes a narrowing of the iliac vein in the pelvis is a factor in pelvic venous
congestion and this is treated by balloon angioplasty and stenting. Sometimes, injection of a foam sclerosant directly into varicose veins of the groin or near the external genitalia with ultrasound or X-ray guidance is adequate for treatment.
Seek a physician with significant experience managing pelvic venous congestion.
I think the most important issue is to make the correct diagnosis. A special type of MRI may need to be done. If you do have PCS, a procedure called embolization may be the least invasive and best option. For more information, I recommend visiting the Society of Interventional Radiology website.