Like many other people who have suffered from nutcracker syndrome, Sarah Cox knows what it’s like to feel pain.
At her worst, she felt constant excruciating abdominal pain that didn’t lessen whether she sat down or stood up.
But Sarah turned out to have an advantage that others didn’t: Her sister worked at University Hospital in Madison, and connected Sarah to an interventional radiologist. That radiologist, in turn, referred her to UW Health’s Renal Autotransplant Program, where she finally found the relief she was looking for.
“The stars and planets aligned,” she said. “I feel so fortunate that I was able to see this doctor my sister worked with, and get the answers I needed.”
Sarah, who is now 38, first started to notice her abdominal pain in 2018. At first, her doctors speculated that it was period pain, but after ordering a pelvic ultrasound in 2019, they diagnosed her with pelvic congestion syndrome (PCS). PCS is when there are varicose veins around the ovaries and uterus that become enlarged and twisted, leading to pain. That was when Sarah’s sister suggested she visit UW Health.
In 2020, Sarah’s interventional radiologist at UW Health, Dr. Jason Pinchot, performed an ovarian vein embolization—a procedure that closes off faulty veins. It provided some relief for a few years, but in 2023, Sarah came back to Dr. Pinchot complaining of pain again. At that point, he ordered a venogram, a medical imaging test that uses X-rays to visualize the veins in the body.
The venogram helped Dr. Pinchot make another diagnosis—nutcracker syndrome. Nutcracker syndrome is a vascular condition in which the left renal vein is compressed, which can lead to flank pain. It just so happened that UW Health had a program that was dedicated to helping patients like Sarah.
In February 2024, Sarah met with Dr. David Foley, a transplant surgeon and the medical director of the Renal Autotransplant Program, and several other key staff members at the clinic. Dr. Foley said he would be able to help her with a renal autotransplant—a procedure in which he removes her left kidney, eliminates compressed veins, and then relocates the kidney lower down in her abdomen to give blood flow for proper kidney function.
“That was when it kind of hit home what a big deal this was,” Sarah said. “But meeting with them and scheduling my surgery was such a relief. I was finally going to have the solution I needed.”
Sarah underwent renal autotransplant surgery in October 2024. Though she experienced some incision pain after surgery, her abdominal pain was gone. And within a few months, she was completely healed. “I feel amazing,” she said. “I just told someone that if it weren’t for my scar, I wouldn’t even know I had surgery. You don’t realize how bad your quality of life was until you feel better. I have a pep in my step again.”
Sarah returned to her job as a hairdresser in January 2025, and now she’s starting to garden again. In March 2025, she and her family were planning a spring break vacation. “It will be really fun, knowing I can walk around and not have to rest every 10 seconds,” she said. “I can just enjoy my time with my family.”