Varicose veins of the small pelvis in women (ectasia, parametria, dilatation or phlebostasis) is triggered by this condition due to the reverse flow of blood through the ovarian artery, which appears due to vascular compression.
The intensification of the development of the disease is pregnancy.
Internal varicose veins of the small pelvis is expressed by intense and prolonged pain in the lower abdomen.
In the literature, varicose veins of the small pelvis are also referred to as "pelvic congestion syndrome", "varicocele in women", "chronic pelvic pain syndrome".
In the overwhelming majority of cases (80%), varicose transformation affects the ovarian veins and is extremely rare (1%) observed in the veins of the broad ligament of the uterus.
According to modern medical approaches, the treatment of VVMT should be carried out not so much from the standpoint of gynecology, but, first of all, from the standpoint of phlebology.
The causes of the appearance of pathology
Most often, ectasia of the pelvic veins is determined in women. Moreover, as a rule, this disease in gynecology is diagnosed in patients aged 20-40 years.
Often, patients with varicose veins of the small pelvis first try to carry out treatment at home. Folk methods, used without the advice and recommendations of a doctor, can lead to the appearance of negative side effects, so after a while you have to go to a phlebologist for a consultation.
The main factors that lead to the appearance of this pathology include:
- Excessively increased physical activity.
- Passive lifestyle.
- Congenital diseases of the walls of blood vessels - weakening, plasticity, underdevelopment.
- Inflammation processes in the pelvic organs.
- Hormonal imbalance.
Pathology of the sexual plan - anorgasmia, pain and the appearance of discomfort during sexual intercourse, which have a psychological etiology of the appearance, while they very often practice interrupted sexual contact.
At the same time, varicose veins of the small pelvis, the treatment and symptoms of this disease are similar to varicose veins on the legs. In this situation, the valves in the veins begin to disrupt the work of the valves that help the flow of blood circulation to the heart muscle.
Dysfunction of the valves appears, which act as a protection for reverse blood flow.
If their work is disrupted, then blood stagnation begins in the veins. Veins filled with blood increase in volume, which further increases the phenomenon of stagnation.
Pelvic venous congestion usually occurs near the vulva, fallopian tubes, uterine region, and may even dilate the veins in the vagina.
First signs and symptoms
A number of basic clinical symptoms indicate the development of varicose veins. The most important of the signs of this disease is unreasonable pain in the lower abdomen, in the pelvic region, often they begin to radiate to the perineum or to the lumbar region. The patient is also annoyed by the abundant discharge of mucus from the vagina, especially in the middle of the monthly cycle.
In addition to the main symptoms, there are also other very important symptoms of varicose veins:
- In certain cases, infertility is noted in women.
- Dysmenorrhea. Manifestation of pain during menstruation.
- Perceptible passage of premenstrual symptoms.
- Irradiation of pain in the groin, lower back and sacrum.
- A symptom of dyspareunia (manifestation of a feeling of discomfort in the vagina or vulva, both during sexual intercourse and after its completion).
- The manifestation of a painful crisis (as a result of a severe hypothermia of the body, excessive physical fatigue, psychoemotional stress).
- The appearance of pain in the abdomen after prolonged overload (dynamic or static).
Faced with this clinical symptomatology, it is necessary to consult a doctor as soon as possible, since this pathology can have a large number of unpleasant complications:
- varicose veins may be a contraindication to natural delivery;
- the work of the reproductive organs is disrupted;
- there is a fear of sexual contact;
- irritability and anxiety appear.
It must also be said that all of the above symptoms can be expressed in different ways, in certain patients all the signs of the disease are noted, and in some only a few of them.
Methods for diagnosing the disease
To establish the correct diagnosis, the patient must undergo a comprehensive examination. If a woman complains of pain that appears for an unknown reason, then the specialist first of all determines all the reasons that are factors in the manifestation of the pain symptom. The patient's lower extremities are carefully examined. So you can identify the manifestation of varicose veins. In some situations, a diagnosis is made by a vascular doctor.
The main diagnostic methods are as follows:
- Ultrasound of the venous system. The examination makes it possible to examine the tortuosity and expansion of the veins.
- Laparoscopy. Determine the varicose veins in the ovarian region.
- CT. It makes it possible to exclude the disease, to identify varicose veins in the ovaries and uterus, to see the enlargement on the monitor, as well as their tortuosity.
- Selective ovarycography. The most accurate examination. It is performed by injecting a contrast agent into the subclavian and femoral veins.
- Doppler ultrasonography. Determines in the veins of the ovaries and uterus a decrease in the systolic speed of the process.
The use of these methods makes it possible to more clearly define the symptoms of the disease.
Degrees and differential approach
To standardize the diagnosis and the possibility of an approach to differential treatment, A. E. Volkov divided varicose veins taking into account the place of formation of venous ectasia and the size of the dilated vessels.
Three stages of this disease are classified:
- the first stage - "corkscrew" movement of the vessel, the size of the vein is not more than 6 mm;
- the second stage - the size of the vein is not more than 7-11 mm during the total type of varicose veins, VR of the arcuate uterine plexus veins, VR of the parametric veins, loose ectasia of the ovarian plexus;
- the third stage - the size of the vein is more than 11 mm during the main form of parametric formation or total type of VR.
Taking into account the severity of the pathology process, you can use medication methods of treatment or surgery.
Methods for the treatment of varicose veins
During stage 1-2 varicose disease, conservative methods of therapy are most often used (remedial gymnastics, NPS drugs, venotonics).
Conservative therapy during the syndrome of venous congestion is symptomatic, which includes the normalization of rest and physical activity, which excludes excessive active loads and prolonged standing.
When the patient has been diagnosed with varicose veins, the treatment procedures are primarily aimed at achieving the following tasks:
- Relief of symptoms of bleeding, pain, etc.
- Restoration of vein tone, increased blood circulation in tissues.
- Cessation of reverse blood flow through the venous system of the ovaries.
It is necessary to realize that even a very high-quality therapy for this pathology will not completely cure varicose veins.
However, adequate treatment will make it possible to prevent the main clinical symptoms and significantly improve the patient's condition.
Treatment of EMCT includes several main components:
- Regular exercises in medical gymnastics to prevent the onset of the disease.
- Course use of drugs during an exacerbation.
Conservative therapy of affected veins
Due to the internal location of the veins infected with pathology, drugs are used orally, it is simply impossible to apply venous ointments and gels.
During this disease, the following drugs are used:
- Horse chestnut extract - to relieve inflammation and swelling.
- On the basis of diosmin - to get rid of high vascular elasticity, prevent damage, reduce permeability.
- Vitamin C - strengthens the vascular walls.
Doctors advise to combine conservative treatment with exercise therapy, as well as using compression underwear. Compression garments are especially required during pregnancy.
Surgical intervention is an extreme method of treatment, which is used if the disease is in a very advanced stage and there is an assumption of VR of the veins.
The surgical operation is selected taking into account the location of the main disruption of the veins and involves the following interventions:
- operation crossectomy - is also used for diseases of the veins of the legs;
- ligation of a vein in the genitals (usually performed simultaneously with perineal miniflebectomy);
- ligation of the ovarian vein.
If an operation is necessary, the choice of appropriate manipulations is quite individual, since everything will depend on the location of the varicose veins.
Exercise and remedial gymnastics
If we consider the necessary physical exercises, then women during this disease need to do at least one of the exercises every day - "birch", "bicycle", "scissors".
A contrast shower in the pelvic area and breathing exercises are also very useful. At the same time, correctly and efficiently performed gymnastics is the fastest way to restore a healthy and normal life.
The simplest but effective exercises are as follows:
- While lying on your back, raise your legs, then bend and raise as high as possible. The exercise is done about 10 times.
- Supine position, stretch your legs, then, bending, pull to the chest area. Run at least 10 times.
- For half an hour, you will need to walk around the room. First - on the toes, then - on the heels, after - raising the knees as high as possible.
- Lying on your stomach, take turns to raise your legs up. In the maximum position, the leg must be fixed for a few seconds. At least 7 approaches for each leg.
Folk recipes and remedies
Varicose veins can be treated at home.
The most famous and common folk methods of treatment:
- Horse chestnut infusion.
- Kombucha tincture.
- Dandelion root tincture.
- Treatment with leeches, which are applied to the coccyx and sacral region.
Diet has an important role in the treatment of varicose veins. The daily diet must be balanced and have enough fiber and natural proteins.
It is also necessary to use a few simple tips that serve as the prevention of BPHMT. Moreover, if they are constantly observed, they can also improve the overall condition of the body:
- Exercise every day.
- Use special tights for the treatment.
- Add more vegetables to your daily diet. Avoid foods that cause constipation.
- During sedentary work, take breaks, you need to walk for at least 10 minutes every two hours.
- Do not abuse alcohol or smoke.
- Do not take hormonal drugs uncontrollably.
- After surgical intervention for VVMT, you need to take prophylactic doses of medications prescribed by your doctor.
If the varicose condition is not treated at all, then after a while the veins begin to increase even more (by 90%), this threatens with serious side effects, including thrombosis. In the remaining 10% of patients with varicose veins, in whom it appeared after pregnancy, the disease does not progress to a more severe stage, however, it never goes away on its own.
If you start the treatment of pathology, you can achieve a full recovery (15-25%, taking into account the severity) or significant improvement (55-60%), especially in the case of the simultaneous combination of the operative and conservative methods. But, one way or another, after complex therapy, lifelong prophylaxis must be carried out, which consists in adhering to the correct lifestyle, regular medication or compression support of the veins.