What is Pelvic Congestion Syndrome?

Pelvic Congestion Syndrome is a condition where there are varicose veins in the lower abdomen and pelvis. Many women are affected by this condition, but may not know that their pelvic pain, heaviness and pressure are caused by varicose veins.

Symptoms

Symptoms of Pelvic Congestion Syndrome (PCS) are: heavy, achy, (anywhere from a dull ache to significant achiness), and/or pressure in the pelvis, pelvic pain that gets worse during a woman’s cycle, leg pain that accompanies the pelvic pain, back pain, and pain after intercourse.

Diagnosis

In our office, a Nurse Practitioner, Physician’s Assistant, or Physician will discuss pelvic symptoms with you. They will determine whether you present with pelvic congestion syndrome symptoms and order an ultrasound to look for varicose veins in the pelvis, labial area and upper thigh. This gives information regarding the sizes of the varicose veins in the pelvis and whether they have propagated to other parts of the body. Once these veins are found, they will also order a CT scan to show the origin of the varicose veins.

Treatment

For treatment of pelvic varices, the doctor will perform a pelvic venogram.
Embolization of a vein: After using an anesthetic to numb a small area of the neck, doctors make a small incision there. Then, they insert a thin, flexible tube (catheter) through the incision into a vein and thread it to the varicose veins. They insert tiny coils, into the vein to block the flow of blood into these varicose veins.

Sclerotherapy: Occasionally, due to the size or position of the veins, the doctor may need to inject the veins with a chemical to close the varicose veins along with the embolization.

Follow Up

We always follow-up with the patient approximately one month post venogram to see if some you the patient’s symptoms have resolved. It may take 1-2 menstrual cycles before significant relief is noticed. Most women we have seen in the office for their post venogram follow-up have described some cramping for the first few days post procedure, and with significant relief in the weeks and months after.

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Varicose Vein Treatment: Understanding What Your Insurance Will Cover

Dealing with treatment of varicose veins can be tricky when it comes to prior authorization with an insurance company. There are many guidelines that need to be followed and they are specific to each insurance company. Examples including vein size, types of veins, pain level, compression stockings and Nsaid use are just a few that each insurance will look for at the time a prior authorization is submitted.

Pre-Authorizing Treatment

At IVC we are very aware of the importance of obtaining the correct measurements and making the patient aware of their responsibility before an authorization can be obtained. No one wants to go into a procedure without being sure that the insurance will pay their part. We want our patients to be relaxed on their procedure date, not stressed about whether they will have an issue with their insurance later on. Because patient care is so important to us, we pride ourselves in knowing what the insurance company needs, we have an open relationship with many insurance companies who appreciate our clinical notes and ultrasound reports and have open communication with us to explain any changes because we are not trying to sneak past their requirements.

Knowing Your Out-of-Pocket Expense

Not only can you have the confidence in our authorization department, we offer what many clinics do not, knowing what your out of pocket cost is before starting the varicose vein treatments. Knowing what your portion of the treatment will cost you will help you decide if the treatment is possible, and prepare with your HSA or Flex Spending accounts. You will hopefully better understand what your deductible, co-insurance and out of pocket max are and how they apply to the treatments you receive at IVC.

Getting started with your new patient appointment will not only educate you on insurance requirements and cost but will also get you started with those requirements and be ready if your deductible is met for the year.