In Reply to: Re: Case 0400_09 -- Pelvic Congestion Syndrome:The Diagnostic Value of Venography posted by Rob Kirsch on May 01, 2000 at 22:40:21:
Doesn't it make sense to embolize gonadal veins if reflux is demonstrated before doing laparoscopy? Embolization is less invasive than laparoscopy and if symptoms resolve you don't need to do anything else.
I find that the majority of OBGyns at least in our area are hostile to our subspecialty and their reasoning is very predictable: Whatever gives them financial benefit is automatically medically indicated. Pretty much all insurance appeals re. UAE that have been reviewed by ObGyns that I have seen have been rejected. I feel that they are betraying their patients and I hope that the public will find out about this and they will take a hit that they fully deserve.
I know that one has to make concessions with the referring physicians but I don't see a medical reason to automatically add laparoscopy to the workup of Ovarian Vein Syndrome.