Women’s Health

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.

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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.

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For more information:

https://www.sirweb.org/patient-center/pelvic-congestion-syndrome–chronic-pelvic-pain/

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.

The great saphenous vein is one of a pair of the longest veins in the body: it starts in the foot and travels all the way up the leg to the thigh (femoral vein). Because it is so long, the great saphenous vein has between 10-20 valves, and when one or several of these valves weaken, varicose veins appear, often causing pain, heaviness and discoloration in the leg.

To ablate the saphenous vein, an Interventional Radiologist makes a small incision into the greater saphenous vein, and a small wire is inserted into the saphenous vein. A special catheter that generates heat from radiofrequency energy, collapsing the saphenous vein.

Eventually, the vein “scars down,” and the body naturally diverts blood flow from the now-closed saphenous vein into the deep veins, improving circulation.

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Sclerotherapy is a minimally-invasive treatment used to treat varicose and spider veins. The procedure may also remedy symptoms like aching, burning, and swelling associated with varicose veins.

A tiny needle is inserted into the vein, and a gentle solution is injected that causes the affected vein to close down, and eventually the vein scars down. Once the affected veins are shut down, the body diverts blood flow into surrounding veins.

Typically, multiple treatments are required for complete spider or varicose vein removal. Elastic compression hose are worn after each treatment.

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Ambulatory phlebectomy is a minimally-invasive surgical technique used to treat varicose veins, often in conjunction with vein ablation and/or sclerotherapy.

The abnormal vein is removed through a tiny incision or incisions using a special set of tools. The procedure is done under local anesthesia, and typically takes under an hour. Recovery is fast, and most patients do not need to interrupt regular activity after ambulatory phlebectomy.

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In some patients, venous compression or blockages in the pelvis can cause swelling in the legs, a.k.a. venous hypertension. An interventional radiologist inserts a catheter over a wire through an incision in your leg into the pelvis to deploy a stent to open the blockage or compression. This can be very effective for reducing swelling and other symptoms of hypertension such as varicose veins, skin pigmentation, and swelling.