Pelvic Congestion Syndrome Technique & Follow-Up w/ Dr. Michael Cumming | BackTable Podcast Ep. 102

In Part 2 of their Pelvic Congestion Syndrome discussion, Dr. Mark Meissner and Dr. Michael Cumming get into their specific techniques, tips and tricks for embolization, and follow up care.
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SHOW NOTES
In this episode, Dr. Mark Meissner and Dr. Michael Cumming join Dr. Michael Barraza to discuss techniques for treating Pelvic Congestion Syndrome. We examine their goals for therapy and why to approach the internal iliac veins first. We discuss which catheters they use and how to approach venograms in a therapeutic way, rather than diagnostic.
We share a new technique for coiling that reduces procedure time and pain for the Pelvic Congestion Syndrome patient. We discuss the challenges of embolization and why we often rely on the sclerosant when using an occlusion balloon. Dr. Meissner and Dr. Cumming tells us about the post-procedure management, why to follow-up after the first menstrual period, and why to make foam using CO2 when a patient has a history of migraines.
We examine the verbiage of the name “Pelvic Congestion Syndrome” and how it leads to misconceptions about its etiology. Dr. Meissner shares his process for treating Nutcracker Syndrome, and we discuss the potential problems of renal vein stenting.
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[@KC-xp9of]

For those fighting their insurance company to get the procedure for PCS, here's what I went through. For 10+ years I've dealt with left side pelvic/groin pain. I had a MRI done on 2017. It stated I had dermoid cysts. My OB decided on a wait and see approach. I desperately needed an ER several times due to how bad the pain was. Then in September of 2022 I was in severe debilitating pelvic/groin pain. Had another MRI done which showed I DID NOT have dermoid cysts. Saw a new OB diagnosed me with 3 more medical conditions I didn't have or didn't show up on the MRi, nor did I have symptoms for them. I got a 2nd opinion with a holistic OB. He did exploratory laparoscopy surgery January 2023. He discovered I had 3 conditions which didn't initially show up on my MRI. One condition he found was pelvic congestion syndrome. I think back at an odd pain I had, which was something heavy resting deep on my hip. Now I know it's blood pooling in that area, and not a dermoid cyst. It took lots of digging to find a vascular doctor in my area, and who was covered by my insurance.
So here's how my vascular doctor fought for me. He had to submit all my medical records to my insurance company (OB, GI reports and MRI and CT reports). Then had to do a " Peer to Peer" review with my insurance company. Basically, this meant my doctor had to explain my symptoms, my history, and why I needed this procedure. After months of waiting, I now have my procedure approved and my procedure is scheduled for July 10th.
It is no joke how debilitating pelvic congestion syndrome is and how depressing, hopeless, and sleep deprived this condition did to me. So I'm extremely thankful for this new technology and for doctors like mine who don't think this pain is all in my head and that I needed cognitive behavioral therapy.