Other Resources
Learn more about these treatments options:
Fallopian Tube Recanalization is a non-surgical procedure to open blocked fallopian tubes, which are the passageways for the eggs to travel from the ovaries to the uterus. Fallopian tubes become blocked due to debris or scar tissue from prior surgeries or serious infections. Recanalization, the medical term for reopening, is most commonly used to treat women who are having trouble conceiving.
Holy Name Medical Center's Interventional Radiologists perform the minimally-invasive procedure, with a very small risk of infection and little exposure to radiation. A physician inserts a small catheter through the cervix into the uterus and injects a liquid contrast agent that flows through the uterine cavity and into the fallopian tubes. The uterus and fallopian tubes are then reviewed using an X-ray to determine if there are any blockages. This is called a hystrosalpingogram, which literally means a uterus-and-fallopian-tube-picture. If one or both fallopian tubes are clogged, a second catheter is inserted through the first and removes the blockage. Physicians are able to unblock at least one fallopian tube in 90 percent of cases.
Patients may feel some pressure and cramping during the procedure and the cramping may continue after the exam but it should not be severe. The actual time reviewing the uterine cavity and unblocking the fallopian tubes is only a few minutes, but the entire procedure may last about a half hour. Patients are able to go home about 30 minutes after the procedure.
Benefits
- Reduced complications compared to open or robotic surgery
- Faster recovery than surgery
- This procedure takes much less time than surgery
- High success rate with the procedure
For decades, millions of women - more than a third of the female population - have suffered with undiagnosed pelvic pain, perplexing physicians and leaving patients with few options. During the last 10 years, specialists have discovered the cause may be hard-to-detect varicose veins in the pelvis, known as pelvic congestion syndrome.
Pelvic congestion syndrome is similar to varicose veins in the legs, a condition caused by malfunctioning valves that do not close properly and allow blood to flow backwards and pool in the veins rather than travel to the heart. The accumulation of blood puts pressure on the veins and causes them to bulge. Varicose veins often cause pain, and in the pelvis, may affect the uterus, ovaries and vulva.
Diagnosing the condition has been difficult because when a woman lies down for a pelvic exam, the pressure on the veins is reduced and they do not appear to bulge as they do when she is standing. Women with this syndrome will typically feel worsening pain through the day when standing.
Surgery may be done to address the condition but it typically involves a hysterectomy along with tying off or removing the veins. Hormone treatment, in the form of birth control, may also be used to decrease symptoms.
Holy Name Medical Center's Interventional Radiologists can perform a minimally invasive treatment that has been shown to successfully treat pelvic congestion syndrome.Risk Factors
- Age - women with this condition are typically 45 years old.
- Number of pregnancies - ovarian veins increase in size with each pregnancy. Women who have never been pregnant do not usually have pelvic congestion syndrome.
- Fullness of leg veins - the same conditions that cause varicose veins in the legs may lead to varicose veins in the pelvis.
- Polycystic ovaries
- Hormonal dysfunction
Symptoms
- Dull, aching pain in the lower abdomen and lower back
- Pain that increases after intercourse, menstrual periods, when tired or when standing and during pregnancy
- Irritable bladder
- Abnormal menstrual bleeding
- Varicose veins on the vulva, buttocks or thighs
Tests
Pelvic congestion syndrome can be diagnosed by an interventional radiologist through several minimally invasive screenings.
- Pelvic venography is considered the most accurate method for diagnosing the condition. A contract dye is injected into the veins of the pelvic organs and an X-ray is taken while the patient is on an incline.
- An MRI is the most non-invasive method of pelvic congestion syndrome but it needs to be adapted to look specifically at pelvic blood vessels.
- Pelvic and transvaginal ultrasounds are not very effective in diagnosing the condition but they may be used to rule out other pelvic disorders.
Treatment
An embolization is the most effective treatment for pelvic congestive syndrome. Using X-rays for guidance, an interventional radiologist inserts a thin catheter into the femoral vein in the groin and guides it to the affected vein. A drug is injected through the catheter that causes the vessel to shrink and eventually dissolve, forcing the blood to be rerouted through other veins. The procedure is successful in eliminating or diminishing symptoms in 85 to 95 percent of patients and may be repeated if necessary. Patients are able to resume daily activities almost immediately.
Uterine Fibroids are common, noncancerous growths that develop in the muscular wall of the uterus. Between 20 and 40 percent of women 35 and older, and 50 percent of African American women, have uterine fibroids of a significant size. They can range in size from very tiny - as small as a quarter of an inch - to larger than a grapefruit. Even the smallest ones can cause intense pain and heavy bleeding. Often, patients are told a hysterectomy is the only effective treatment for debilitating symptoms - about one-third of the 600,000 hysterectomies performed annually in the United States are due to fibroids.
Patients have another option. Holy Name Medical Center's Interventional Radiologists can perform a minimally invasive procedure - a uterine fibroid embolization - to treat uterine fibroids without a hysterectomy and open surgery. They guide a small catheter through an incision in the wrist or groin to the uterine arteries that supply blood to the uterine tumor. Tiny particles - about the size of a grain of sand - are injected into the arteries that supply blood to the fibroids, which causes them to shrink and die.
About 85 to 90 percent of women who undergo a uterine fibroid embolization experience significant or total relief from symptoms. Recurrence of treated fibroids is extremely rare. The American Society of Obstetricians and Gynecologists recommend a uterine fibroid embolization for women who do not want a hysterectomy.
Symptoms
- Pelvic or back pain
- Heavy menstrual bleeding
- Prolonged menstrual periods
- Sensation of fullness or pressure
Benefits
- No hysterectomy
- Little or no hospital stay
- Minimal post-procedure discomfort
- Faster recovery
- Fewer complications
