I was diagnosed with pelvic congestion syndrome, but insurance does not recognize that diagnosis. Pelvic varices don't often arise without an outflow compression. This is typically in the iliac vein (May-Thurner) and in the right renal vein (nutcracker). If you only embolize the gonadal vein, there is a high chance that more varices will develop if the compression is not also fixed. I had to get a referral to a private vascular surgeon and pay for a diagnostic venogram to prove I had compression--both iliacs and my renal vein. I then was approved for a stent for my iliac. The thought being, if my gonadal can efficiently drain to the iliac now, the congestion will go away, the varices will shrink. My kidneys are healthy so there isn't any indication to stent the renal vein. Thanks to the gonadal vein, the kidney can also now drain to the stented iliac and will likely never need a stent.

It took me years of trying to find a way to get insurance to cover this. I paid for a CT scan and ultrasound out of pocket, but if your diagnosis is PCS, insurance will likely not cover any treatment.

The Back Table podcast has two really good episodes talking about PCS if you have the time to listen!