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Pelvic congestion syndrome
Women with pelvic congestion syndrome are typically less than 45 years old and in their child bearing years.
Ovarian veins increase in size related to previous pregnancies. Pelvic congestion syndrome is unusual in women who have not been pregnant.
Chronic pelvic pain accounts for 15% of outpatient gynecologic visits.
Studies show 30% of patients with chronic pelvic pain have pelvic congestion syndrome (PCS) as a sole cause of their pain and an additional 15% have PCS along with another pelvic pathology.
The chronic pain that is associated with this disease is usually dull and aching. The pain is usually felt in the lower abdomen and lower back. The pain often increases during the following times:
- Following intercourse.
- Menstrual periods.
- When tired or when standing (worse at end of day).
Other symptoms include:
- Irritable bladder.
- Abnormal menstrual bleeding.
- Vaginal discharge.
- Varicose veins on vulva, buttocks or thigh.
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.
Fallopian tube blockage
The most common cause of female infertility is a blockage of the fallopian tube through which eggs pass from the ovary to the uterus. Occasionally, these tubes become plugged or narrowed, preventing successful pregnancy.
Interventional radiologists can diagnose and treat a blockage in the fallopian tubes with a nonsurgical procedure known as selective salpingography. In the procedure, which does not require an incision, a catheter is placed into the uterus. A contrast agent, or dye, is injected through the catheter, and an X-ray image of the uterine cavity is obtained. When a blockage of the fallopian tube is identified, another catheter is threaded into the fallopian tube to open the blockage.
People with certain diseases or medical conditions sometimes require that tubes be placed into the central veins so that they can receive medications or nutrients directly into the blood stream, or so blood can be drawn. Once, surgery was required to insert these tubes, but today these procedures can be done without surgery by an interventional radiologist
Interventional radiologist can insert many kind of venous central lines according to the patient medical needs include.
.Hickman line for chemotherapy aim.
Permacath line for Dialysis access or plasma pheresis.
Picc line for antibiotics, TPN, chemotherapy.
Bile Duct Obstruction
In some patients, such as those with liver cancer or individuals who have had an injury to the liver, the bile ducts become blocked and bile cannot drain from the liver. The interventional radiologist places a catheter through the skin and into the bile ducts to drain the bile. In some cases, a small metal cylinder, called a stent, is placed in the liver to hold the blocked area open. A catheter may also be placed to drain bile in patients who have a hole in the bile ducts or as preparation for surgery on the bile ducts.
Urinary tract interventions
Interventional radiology can perform many procedures related to the urinary tract includes:
- Nephrostomy tube insertion (tube placed in the kidney pelvic to drain out the urine in hydronephrosis cases).
Nephrouretrostomy catheter placement for ureteric structure cases.
Ureteric balloon dilatation.
PCNL (stone extraction access creation).
All mention kind of procedures done without surgical incision or even need for general anesthesia.
Vascular anomalies treatment
One of the major challenge human diseases to treat is the vascular anomalies, interventional radiology field have great achievement in treating such medical problem with minimal invasive interventions through the sclerotherapy procedures.
Interventional radiologist can inject the affected vessel (under ultrasound and fluoroscopy guidance) using scelosing drugs several sections.