Varicose veins (varicose veins) are a disease accompanied by an increase in length, the formation of serpentine pathological curvature of the vessels, irreversible cystic enlargement of their lumen and valve insufficiency. The lower pelvic organs are involved in the process of varicose veins. The mechanisms of disease development are different. Doctors cover the perineal area, external and internal genitals as atypical localizations.
General information about pathology
The process of blood flow through the arteries is such that under physiological conditions, the initial conditions for the development of blood stasis and flow are created.
Varicose veins of the vulva (VV) - dilation of the vessels of the external genitalia. The disease manifests itself in women suffering from varicose veins of the pelvis and legs, as well as in pregnant women. In 30% of cases, pelvic varicose veins cover the perineum and vulva.
The beginning of treatment of the disease is delayed due to the fact that it is located in an intimate place. Women are shy. In some cases, patients do not feel pain or discomfort. However, not only during pregnancy and during pregnancy, varicose veins of the lips continue with complications: thrombotic occlusion (thromboembolism), sexual dysfunction, pain in the perineum, psychoemotional problems and family conflicts.
The mechanisms of pelvic vascular occlusion are not fully understood. The cause of the initial form of the disease is a malfunction of the valves of the gonadal (ovarian) vessels. This causes blood to flow back and increases the pressure in the venous nodes of the lower pelvis. Lack of caps can be acquired or congenital. It gets worse with age or pregnancy.
The secondary form of pelvic organ VVV is associated with gynecological pathologies: endometriosis, pelvic tumors.
Diagnosis of the disease is difficult due to the lack of specific symptoms of its course. It is based on ultrasound (ultrasound) results.
The Valsalva test is used during sonographic examination to distinguish between primary and secondary forms of pathology. Pelvic varicose veins are negative due to the secondary cause.
Varicose veins of the lips with VBT
A doctor's examination is required to diagnose varicose veins of the lips. The symptoms of the disease are:
- varicose veins in the genitals;
- pain in the external genitalia;
- feeling of heaviness and burning in the perineum;
- swelling of the perineum by the end of the day.
Chronic pelvic pain is less common (30% of cases).
Once diagnosed, a study is performed to determine the degree of complexity of the pathological process and to determine adequate treatment. A number of events are held:
- Examination of the vessels of the perineum and legs with ultrasound angioscanning - USAS;
- ultrasound examination of pelvic vessels, including vaginal, uterine, parametric, ovarian, iliac, inferior vena cava and renal vessels;
- Multispiral computed tomography (MSCT), selective ovaricography and pelvic phlebography (SOFT) are performed according to the instructions.
Doctors call VBT a characteristic feature of varicose veins on the labia, the disease develops continuously and is associated with the transformation of intrapelvic vessels.
Treatment of varicose veins of the vulva with varicose veins of the lower pelvic cavity
IV treatment is prescribed based on symptoms and diagnostic results.
Non-steroidal anti-inflammatory drugs and phlebotropic drugs are prescribed in the complex drug therapy for the treatment of systemic chronic venous pathology.
Prescribe pharmacotherapy with antiplatelet agents, intrapelvic blockade with antihypoxans, physiotherapy with ultrasound, therapeutic exercises. Antioxidants and enterobiotics are added to therapy.
According to the instructions, phlebosclerosis is treated - sclerotherapy. The ship is "sealed" with drugs and lasers. Suspends. The procedure does not use special anesthesia. It is performed in an outpatient setting and has a cosmetic effect.
Surgery is indicated to remove the vessels with the abundance of pelvic vessels, dilation and blood flow back from the gonadal (ovarian) vessels. Removed during varicose growth of small lips.
Varicose veins of the vulva during pregnancy
Pregnancy is the first most common risk factor for the onset of VVV. A significant and sustained increase in excess progesterone concentration in the early stages of pregnancy reduces venous tone and aggravates blood flow disturbances. VBT, which covers the perineum and vulva, is also associated with compression of large veins (iliac veins and inferior vena cava) in the retroperitoneal region by the pregnant uterus.
Doctors recommend compression garments during pregnancy.
Often, varicose veins of the vulva are bilateral. Symptoms of the disease:
- an obvious increase in vulvar vessels during the first 18 to 24 weeks of gestation from 12 weeks with repeated pregnancies;
- discomfort in the groin;
- pulling, pain, dull pain in the pelvic region;
- pain during sexual intercourse;
- itching of the vulva;
- swelling of the genitals and perineum.
Pathological symptoms progress with pregnancy. In addition to increasing the size of varicose veins, its compression is determined in the third trimester. A characteristic symptom of IV is a combination of inguinal varicose veins or varicose veins in the legs during pregnancy.
Instrumental examination of varicose veins of the lips in pregnant women is limited to their ultrasound examination, as well as ultrasound examination of the legs, because painful changes in the venous bed are subject to involution in the postpartum period.
In most cases (approximately 80%), the symptoms of varicose veins begin to decrease from the first days of pregnancy during pregnancy and are minimized 2-8 months after birth. There is no complete return of the diameter of the vessels to their original values.
In 4-8% of women, the disease does not disappear after IV birth and progresses.
An interesting feature is the relationship between the end of the feeding period or the rate of disappearance of varicose veins in the groin in women and a decrease in breastfeeding. The shortened lactation period is accompanied by the reduction and disappearance of dilated vessels, and vice versa. This proves that varicose veins of the perineum during pregnancy are associated with changes in hormonal levels.
Treatment of varicose veins of the perineum during pregnancy
Phlebotropic treatment is the basis of treatment of varicose veins during pregnancy. Fertility begins in the fourth, second and third trimesters in most women. Diosmin drugs can be used during this period. The severity of the symptoms of the pathology is reduced by a micronized purified flavonoid fraction. Itching is relieved with zinc paste and H1-histamine receptor blockers.
In prophylactic doses, low molecular weight heparin prevents venous thrombosis and pulmonary embolism (blockage of blood vessels).
As an option for the treatment of compression, it is prescribed to wear tight elastic underwear using latex or gauze pads. Eliminates puffiness & heaviness of lipsA special form of compression for women with vulvar varicose veins helps a lot.
If a complication such as local thrombophlebitis develops, surgical treatment is required.
When a conglomerate of varicose veins is found in the genitals, the question arises as to the method of delivery. Natural birth is allowed with varicose veins of the vulva. Conversely, the risk of surgery during a caesarean section is higher than the onset of bleeding from painful veins during childbirth. This rarely happens. However, caesarean section is often performed with varicose veins of the vagina.
Prevention of varicose veins of the lips
The main factor in the formation of varicose veins in the abdomen is the carrier of the fetus. Given that there are a number of limitations to many therapeutic interventions during pregnancy, it is difficult to name any prophylactic method. Here are some tips:
- exclude physical and static stress;
- to follow a diet;
- perform therapeutic exercises that accelerate blood flow from the legs and lower pelvic organs;
- In case of vascular dysfunction, varicose veins before pregnancy, it is necessary to take phlebotropic drugs, wear compression underwear.
An effective method of prevention is surgery on the ovaries, surgery for other pathologies associated with varicose veins. This reduces the phenomenon of pelvic venous occlusion, reduces the risk of varicose veins in the labia.
Vulvar varicose veins are a common disease in women with varicose veins in the pelvis, legs or during pregnancy.
In order to improve the quality of treatment of patients with chronic venous diseases, it is important to identify the disease, differentiate the diagnosis and treatment of this condition.