PGAD - persistent genital arousal disorder

[nypain]

I wanted to provide an update. I had my venogram recently, and the vascular surgeon wants me to have more imaging and is considering bringing me back for stenting and embolization, which may or may not help (trying to have some hope but not get my hopes up).

The results did show May-Thurner syndrome, as well as possible Nutcracker syndrome and ovarian varicosities:

Venography was performed of the inferior vena cava as well as left common iliac, external iliac, common femoral and femoral veins. It demonstrated severe compression of the left common iliac vein, large lumbar collaterals more peripheral to the CIV lesion.. Intravascular ultrasound was also performed of the inferior vena cava and left common iliac, external iliac, common femoral and femoral veins and this demonstrated severe compression at the origin of the left common iliac vein whereby the cross-sectional surface areas were reduced to essentially the size of the catheter. An Omni Flush catheter was then used to cannulate the hypogastric vein and an exchange was performed with a quick cross catheter and serial pelvic venograms in an RAO and LAO position were performed which demonstrated some pelvic varices. The decision was made to evaluate the left ovarian vein and cannulated the left renal vein. Attempts were made to cross the left renal vein lesion however there appeared to be an area of stenosis in the left renal vein and catheters could not cross it adequately with this left-sided access. Power injector was used to perform venography which demonstrated patent right right renal vein and left renal vein orifice but more distal flow into the kidney was not well-seen again suggestive of stenosis and potentially nutcracker physiology. T therefore decision was made at this time to not proceed with any iliac vein stenting and to obtain further axial imaging and return if needed via IJ or right-sided access for further push ability and access.

[Violet M]

That's a really difficult decision. It seems like before having the stent/embolization procedure, you would want to know the possible risks associated with it. Hopefully the vascular surgeon would explain that to you.

Since your MR imaging showed some abnormalities in the area of the pudendal nerve, have you considered trying a pudendal nerve block to confirm or rule out pudendal nerve involvement?

Violet