Once a diagnosis is made, if the patient is symptomatic, an embolization should be done. Embolization is a minimally invasive procedure performed by interventional radiologists using imaging for guidance. During the outpatient procedure, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the femoral vein in the groin and guides it to the affected vein using X-ray guidance. To seal the faulty, enlarged vein and relieve painful pressure, an interventional radiologist inserts tiny coils often with a sclerosing agent (the same type of material used to treat varicose veins) to close the vein. After treatment, patients can return to normal activities immediately.
Additional treatments are available depending on the severity of the woman's symptoms. Analgesics may be prescribed to reduce the pain. Birth control pills may decrease a woman's hormone levels causing menstruation to stop and may be helpful in controlling her symptoms. Surgical options include a hysterectomy with removal of ovaries, and tying off or removing the veins.
In addition to being much less invasive and less expensive than surgery, embolization offers a safe, effective, minimally invasive treatment option that restores patients to normal. The procedure is very commonly successful in blocking the abnormal blood flow. It is successfully performed in 95-100 percent of cases. Between 85-95 percent of women have improvement in their symptoms after the procedure. Although the symptoms are usually improved, the veins are never normal and, in some cases, other pelvic veins are also affected, which may require further treatment.
Reprinted with permission of the Society of Interventional Radiology -¬ 2004, www.SIRweb.org. All rights reserved.