Varicose veins of the small pelvis: treatment

causes of pelvic varicose veins

Although several thousand observations have been described with diagnosis and subsequent treatment, the disease is poorly understood.

The variety and non-specificity of the clinical picture of small pelvic varicose veins lead to gross errors that affect the future outcome of the diagnosis.

Features of varicose veins of the small pelvis

Pelvic arteries are several times longer than arteries, which causes them to become more obstructed. This is due to the phylogeny of the vascular system of the pelvic region. The pelvic vessels are highly adaptable and potentially prone to remodeling, which contributes to the formation of a tightly intertwined network.

The speed and direction of blood flow is regulated by valves controlled by complex humoral mechanisms. Valves balance the pressure in different parts of the venous network.

When the valves stop functioning, blood stasis develops, which leads to vascular pathology and the formation of varicose veins. The peculiarity of pelvic vessels is that the large ligaments of the uterus, which keep the vascular lumen wide, narrow it and cause pathology.

Causes

Pathological pelvic venous dilatation can be due to the following reasons:

  • disruption of blood flow;
  • Vascular trunk incision;
  • Compression of the supply bodies by the altered position of the uterus, for example, in retraction;
  • valve insufficiency of the ovarian vein (congenital or acquired);
  • Obstructive postphlebitic syndrome;
  • Connective tissue pathology;
  • Arteriovenous angiodysplasia;
  • Prolonged sitting, heavy physical labor;
  • Varicose veins of the lower extremities;
  • Pregnancy (3 or more) and childbirth (2 or more);
  • Diseases of the female genital area (chronic salpingo-oophoritis, ovarian tumors, uterine fibroids and genital endometriosis);
  • adhesion of pelvic organs;
  • Obesity.

Classification by severity

The following degrees differ in the size of the dilated vessel:

  • up to 0, 5 cm, "turbulence" ship course;
  • 0, 6-1 cm;
  • More than 1 cm.

Disease variants

  • varicose veins of the perineum and vestibule of the vagina;
  • small pelvic venous occlusion syndrome;

symptoms

  1. The most common - frequent pain in the lower abdomen, perineum after prolonged static and dynamic loading. Pain, hypothermia, fatigue, stress increase in the second stage of the period after the exacerbation of various diseases.
  2. Feeling "out of place", pain during and after sex.
  3. Dysmenorrhea - menstrual disorders, including pain.
  4. Excessive secretion of the genital glands.
  5. Blood stasis causes infertility, pregnancy, abortion.
  6. Disorders of urinary excretion due to dilation of the vessels of the bladder.

Diagnostics

Diagnosis of the disease with complaints is successful only in 10% of cases.

Palpation of the inner walls of the pelvis allows you to feel the elongated seals and venous nodules. When looking in the mirrors, cyanosis of the vaginal mucosa is visible.

diagnostic options for pelvic varicose veins

The selection procedure is an ultrasound examination with a color Doppler map, which allows to detect not only varicose ovarian vessels, but also venous thrombosis, post-thrombophlebitic occlusion. Ultrasound shows "worm-like" structures that are localized on the lateral surface of the uterus and do not reflect the signal.

The Doppler effect is based on the blue and red colors of venous and arterial blood flow, respectively.

With the help of a special program, the ultrasound machine recognizes the movement of blood from the sensor and calculates the speed of blood flow in the other direction and the type of vessel.

But the exact definition of a vein or artery remains with the doctor. The Doppler method works in almost all cases, exceptions to the rules are dictated by our body, because the blood flowing from the heart is not always arterial, and vice versa.

Thus, the ultrasound diagnostician sees this artery or venous artery, its size, the speed of blood flow in it, and many other indicators that a normal person does not need, but plays an important role in making a diagnosis. Transabdominal and transvaginal sensors are used for this purpose.

In 5. 7% of cases, the disease is diagnosed by chance. Normally, the diameter of the vena cava is 0. 4 cm.

CT and MRI are extremely accurate. With these methods, it is possible to detect the accumulation of varicose veins in the uterus, ovaries and ligaments of these organs. It is possible to identify concomitant pathology.

A very reliable method is phlebographic research.

The contrast is at the height of the Valsalva test, against blood flow. This allows you to see the valve failure in full.

Left rethngenorenoscopy, renal phlebography, superselective phlebovarioscopy and phlebovography are also used on both sides. These methods allow to determine the hemodynamic and anatomical changes in the renal vessels and gonadal veins.

Superselective fleboovarioscopy is performed with contralateral femoral or subclavian vein catheterization of gonadal veins, followed by contrast injection.

Most of the blood from the uvine plexus varicose veins is discharged through the ovarian vein. However, in conditions of hypertension, the extraorganic enters the internal iliac vein through the uterine vessels. The vascular plexus in which the outflow can occur includes the sacral and bladder plexuses.

Left-sided phlebovaricography has 3 stages of venous stasis in the uviform plexus of the left ovary:

  1. There is no discharge from the left ovarian plexus or an additional short path follows.
  2. There is an extra long way to go.
  3. Two additional exits appear, or one add-on and auxiliary.

In stages 2 and 3, varicose veins of the uviform plexus of the right ovary are formed.

Laparoscopy is used for differential diagnosis. Pathologically mixed vessels are located in the ovarian region, in the direction of round and wide ligaments. They resemble large cyanotic conglomerates with a thin and tense wall.

The complexity of the diagnosis lies in the fact that the disease often hides behind the symptoms of an inflammatory process, characterized by clinical manifestations, such as endometriosis, prolapse of internal organs, postoperative neuropathy and many extragenital diseases.

Treatment

The main goal of treatment is to eliminate vascular reflux. Conservative treatment is used in the early stages of the disease. Surgery is the method of choice in the later stages of the disease.

Conservative treatment

drug treatment of varicose veins of the small pelvis

Normalizes venous tone, improves hemodynamics and trophic processes.

Symptomatic treatment for individual symptoms. Non-steroidal anti-inflammatory drugs for pain, for bleeding - hemostatic therapy.

The main drugs in conservative treatment are venotonic drugs and antiplatelets.

Phlebotonics - improves the tone of the vascular wall and increases blood flow. With this disease, it is better to consult a gynecologist about some medications.

Physiotherapy is an important method.

Surgical Treatment

  1. Resection of varicose veins.
  2. Gonado-caval maneuver.
  3. Sclerosis on laparoscopy.
  4. Ovarian vascular occlusion using X-ray endovascular methods.

Folk remedies

Since the main factor in the onset of the disease is the weakness of the valve apparatus, all folk remedies used for varicose veins of the lower extremities are also used for this pathology.

The most commonly used: common hazelnut, hops, nettle, horse chestnut, dandelion root, kombucha, willow, oak, St. John's wort, rope, pollen and more.

Effective: treatment with oak, chestnut, willow, chamomile, pharmacy, dried herbs, St. John's wort, string baths.

Prevention

  1. The first thing you should do if you have any of the above complaints, prognosticators, or illnesses is to contact your gynecologist.
  2. It is necessary to normalize the work schedule and rest, try not to stay upright for a long time, exercise.
  3. Exercise to prevent "pedal", "foot tree", "scissors legs"
  4. Stick to a diet: Eat foods high in vitamins E, P, C, try to eat only white meat, low-fat meat, replace it with fruits, vegetables, grains.
  5. Drink plenty of fluids, but not less than 1. 5 liters a day.
  6. Get rid of excess weight and bad habits.
  7. Consult your doctor about wearing tight-fitting clothes, it will improve blood flow from the lower extremities and thus reduce congestion in the pelvis.
  8. Avoid baths, saunas, steam rooms, hot baths.

To avoid getting a difficult disease to diagnose, you should follow the preventive recommendations listed above. Treat your health as the most valuable thing in life.

You should see your doctor for the slightest suspicious symptoms that you can't get rid of in a few days. He must provide you with highly qualified assistance and relieve suffering.