In this article, you will learn: why do varicose veins of the pelvis is considered a separate disease and not a form of varicose veins of the legs, one the disease can occur and why. Manifestations and diagnosis of this pathology, as it is properly treated, the chances of recovery.
Varicose veins of the pelvis – is the weakening of the walls of inner or outer veins of the pelvic area, leading to excessive extension of their diameter. Varicose changed veins are not able to provide the outflow of blood from the pelvic organs, which leads to its stagnation, and the complete destruction of the vascular wall. As a result, damage to the structure and functions of the female reproductive system.
Early stages of the disease cause only minor discomfort in the vulva and abdomen. Women with advanced forms of pelvic varicose veins suffer from constant severe pain, various gynecological diseases, infertile, have a cosmetic defect in the form of tortuous dilated venous nodes on the perineum, labia or entrance to the vagina.
The disease can be completely cured, but to prevent a relapse prevention necessary for life. Dealing with this problem together vascular surgeons, obstetrician-gynecologists.
Varicose veins of small pelvis in males like in women does not happen. But such a disease exists – varicocele. Mechanisms and manifestations are similar to those in pelvic varicose veins. Dilatation occurs in the left testicle and the spermatic cord due to the fact that the left Vienna egg stagnates the blood. She is thrown back from the left renal vein, which flows into Vienna.
The essence of the disease, how serious it is
The outer and inner female sex organs are well krovosnabjaemah. In order to provide sufficient blood flow need a powerful network of venous vessels. Therefore, the venous system of the pelvis in women is well developed. Every vein has a solid wall, provided with valves connected with passing near the veins. It all forms a coherent venous network of the pelvic region which collects blood from the perineum, external reproductive organs (vulva, vagina), special structures (ovaries, uterus), and transportorul it at the bottom Polow vein.
Varicose changed veins of the pelvis differ from the healthy in that they:
- Expanded in diameter;
- Are filled with blood;
- Excessively convoluted;
- Have protrusions in the form of nodes;
- Flabby and weak.
Pelvic veins affected by varicose veins, can collect the blood from the external genitalia and other organs, but not able to transport it to larger vessels (the Vena cava). This leads to the fact that the blood stagnates in the pelvis, and penetrating through the venous wall affects those tissues, which needs to flow away. They become swollen, inflamed and lose their functions.
But most of all varicose veins of the pelvis danger:
- Various disorders of the ovaries;
- Uterine bleeding disorders and miscellaneous;
- Infertility, threatened miscarriage and inability to have a natural birth;
- Formation of blood clots in the lumen of the varicose changed veins that threatens their separation from the place of education and migration in the heart and pulmonary vessels. This is the most dangerous complication, life-threatening – pulmonary embolism (PE).
Reasons
Basically varicose veins of the pelvis happens in Mature women:
- Up to 20 years – 20%;
- 20-30 years – 30%
- 30 – 45 years – 50%
Mechanisms of varicose degeneration of the venous system of the pelvis:
- (80%). They are the main veins that collect blood from the uterus and ovaries and carry it directly into a hollow (right) or renal (left) of Vienna. If failure occurs, it completely blocks the venous outflow.
- Uniform weakening or destruction of the venous wall all the pelvic veins – they are all at the same time expand and not able to contract to propel blood into the overlying departments.
- Reverse reflux of blood from deep vein of the thigh in the superficial sexual vein, which is collecting blood from the perineum and external genital organs, prevents the outflow. As a result, the pressure in it increases, and its trunk and all tributaries of varicose expanded.
The immediate causes of the launch of these mechanisms might be the following:
- Congenital weakness or dysplasia (underdevelopment) of the venous wall and valves.
- Hormonal changes in the female body (puberty, pregnancy, menopause, ovarian disease).
- Frequent inflammation, endometriosis, surgery, adhesions in the pelvis.
- Moved thrombosis and thrombophlebitis of the pelvic veins.
- Heavy physical labor.
- Prolonged lying down or sitting.
- Overweight.
- Pregnancy and childbirth.
- Regular interruption of sexual intercourse for many years, especially in the absence of orgasm.
- Bend uterus posteriorly or anteriorly.
- Pelvic tumors.
- Prolapse of the uterus.
Extent of varicose veins classification
On anatomical grounds (prevalence) varicose veins of the pelvis are divided into three types:
- Venous congestion in the pelvis;
- Perineal varicose veins, etc.;
- Combined forms.
To reflect pathological changes in the disease is divided into three levels:
- First the dilated vessels of any organ plexus of the pelvis do not exceed a diameter of 0.5 cm, an excessively convoluted.
- The second is the diameter of the veins is increased to 1 cm, the process is extended to not only to plexus organs(uterine, ovarian), but some of them (okolomatocnah cellulose).
- The third expansion (ectasia) of more than 1 cm, affecting all vessels – blood, near the bodies, and trunk (the trunk of ovarian vein).
The higher the degree of the disease, the worse dilated veins and heavier congestion in the pelvis.
Characteristic symptoms
Women with varicose veins of the pelvis note:
- Persistent or recurrent pain in the abdomen, worse in the evening or after exertion predominantly in the second half of the cycle (close to monthly). At 3 degrees the pain can be very strong.
- Itching, burning, swelling and lividity of the genital organs.
- Painful periods and intercourse.
- Heavy menstruation and uterine bleeding, irregular cycle.
- The inability to become pregnant.
- Thick twisted veins in the region of the perineum and labia.
- Frequent painful urination.
- Pronounced symptoms of premenstrual syndrome.
Diagnosis
To confirm the diagnosis is carried out:
- Ultrasound through the abdomen and through the vagina (transvaginally) with the use of special sensors – Doppler and duplex treatment of veins of the pelvis. The easiest and most informative method.
- Endovascular venography the introduction of special drugs in the ovarian vein.
- Computed tomography with contrast.
- Diagnostic laparoscopy.
Treatments
Varicose veins of the pelvis together to treat the vascular surgeons or obstetrician-gynecologists. According to modern concepts, the treatment consists of the following areas:
- Normalization lifestyle;
- Conservative medical treatment;
- Compression and other therapy;
- Surgical treatment.
To cure varicose veins of the pelvis. The specialists make an individual treatment plan, and sick women needs to stick to for life recommendations for treatment and prevention.
1. Normalization of lifestyle
Because the wrong way of life is a prerequisite and the direct cause of varicose pelvic veins, its normalization will help to recover:
- Exclude long stay standing or sitting (more than 2-3 hours without a break).
- Do not lift heavy objects and refrain from strenuous physical activity.
- During the day do handling exercises for the pelvis (exercise birch, bike) or just lie down for 10-15 minutes with elevated above the level of the body by the pelvis.
- Reduce weight (obesity).
- Do not take a hot bath, replace it with a cold shower.
- Abstain from alcohol and Smoking.
2. Drug therapy
Treatment of varicose veins pelvic any degree is not possible without medical support. At the first degree it is a major medical event, while the second and third complements comprehensive treatment.
Used such drugs:
- Special medicines that strengthen the veins.
- Anticoagulants – thin blood to ease its progress through the vessels.
- Drugs that improve the microcirculation.
Additional groups of drugs prescribed in view of the existing deviations in the body:
- Preparations of female sex hormones (with hormonal disorders).
- Painkillers and anti-inflammatories.
- Drugs to stop blood styptic drugs for the treatment of uterine bleeding.
3. Compression therapy
One of the effective means in the treatment of varicose veins in the vulva and the perineum is a compression effect. The principle of this method is similar to the use of elastic bandages for varicose veins of the legs. Compression (compression) of the superficial veins from the outside contributes to their evacuation from the blood. To create this effect able special tights or shorts with compression therapy hosiery. They can be purchased in specialized pharmacies, shops, salons, medical products individually choose the right size and strength of compression.
Sclerotherapy – a puncture of the varicose veins with the introduction of a special clearance of drugs that cause sticking. This treatment is carried out at the outer (subcutaneous) pelvic varicose veins without hospitalization in the hospital. The internal veins can also be treated, but this procedure is technically more complex and takes place in the operating room.
4. Surgical treatment
Varicose veins of small pelvis may be better treated by surgery if:
- 2-3 degrees of the disease;
- The rapid progression of the disease;
- Planning pregnancy;
- Expressed pain syndrome;
- Regular uterine bleeding and other gynecological disorders.
Principal operations in pelvic varicose veins:
- Laparoscopic – a special operation through the punctures of the abdomen. Perform the ligation, the intersection or the removal of the ovarian vein. This eliminates backward reflux of blood through it.
- Removal of varicose veins through small punctures or incisions of the skin are removed modified saphenous vein is tied off external pudendal vein to the point where the femoral vessels.
- Gynecological intervention – removal of tumors, removal of bends of the uterus.
Forecast
If you do not treat varicose veins of the pelvis, over time, they expand even more (95%), which faces dangerous complications. The remaining 5% of women with subcutaneous varicose veins of the perineum 1-2 degrees from which it emerged after the birth, the pathology is not amplified, but never go away by itself.
If you treat the disease, it is possible to achieve complete recovery (10-50% depending on the degree) or significant improvement (45-50%), especially in the case of a combination of surgical techniques with conservative. But in any case, after a comprehensive treatment should be lifelong prophylaxis consisting in adherence to recommendations on lifestyle, medication or periodic compression to support weakened veins.