From this article you will learn: why varicose veins of the small pelvis are considered a separate disease, and not a type of varicose veins of the legs; who may get this disease and why. Manifestations and diagnosis of this pathology, how to treat it correctly, chances of recovery.
Varicose veins of the pelvis are weakening of the walls of the internal or external venous vessels of the pelvic region, leading to excessive expansion of their diameter (ectasia). Varicose veins are not able to ensure the outflow of blood from the pelvic organs, which leads to its stagnation and complete destruction of the vascular wall. The result is a disruption of the structure and functions of the female reproductive system.
The initial stages of the disease cause only minor discomfort in the external genitalia and lower abdomen. Women with advanced forms of pelvic varicose veins suffer from constant severe pain, various gynecological diseases, are infertile, and have a cosmetic defect in the form of convoluted dilated venous nodes on the perineum, labia or at the entrance to the vagina.
The disease can be completely cured, but lifelong prevention is necessary to prevent relapse. This problem is dealt with jointly by vascular surgeons or phlebologists and obstetrician-gynecologists.
Varicose veins of the small pelvis in men do not occur in the same form as in women. But a similar disease exists - varicocele. The mechanisms of occurrence and manifestations are similar to those of pelvic varicose veins. Vein dilatation occurs in the left testicle and along the spermatic cord due to the fact that blood stagnates in the left testicular vein. It is thrown back from the left renal vein, into which the testicular vein flows.
The external and internal female genitalia are well supplied with blood. In order to ensure sufficient outflow of incoming blood, a powerful network of venous vessels is needed. Therefore, the venous system of the pelvis in women is well developed. Each vein has strong walls, is equipped with valves, and is connected to nearby veins. All this forms a smoothly functioning venous network of the pelvic region, which collects blood from the perineum, external reproductive organs (vulva, vagina), intrapelvic structures (ovaries, uterus), and transports it to the inferior vena cava.
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Varicose veins of the pelvis differ from healthy ones in that they:
Pelvic veins affected by varicose veins can collect blood from the external genital and intrapelvic organs, but are not able to transport it normally to larger vessels (vena cava). This leads to the fact that the blood stagnates in the pelvis, and penetrating through the venous wall, it affects the tissues from which it should flow. They become swollen, congested, inflamed and lose their functions.
But most of all, varicose veins of the small pelvis are dangerous:
Pulmonary embolism
Mostly, varicose veins of the pelvis occur in mature women:
Mechanisms of varicose degeneration of the pelvic venous system:
The immediate reasons for the launch of these mechanisms may be:
Causes of varicose veins of the pelvis in women
Based on anatomical characteristics (prevalence), varicose veins of the small pelvis are divided into three types:
To reflect the nature of pathological changes, the disease is divided into three degrees:
The higher the degree of the disease, the worse the dilated veins and the more severe the stagnation of blood in the pelvis.
Women with pelvic varicose veins note:
Symptoms of varicose veins of the pelvis in women
To confirm the diagnosis:
Varicose veins of the pelvis are jointly treated by vascular surgeons or phlebologists with obstetricians and gynecologists. According to modern ideas, treatment consists of the following areas:
It is possible to cure varicose veins of the pelvis. To do this, specialists draw up an individual treatment plan, and sick women must adhere to treatment and preventive recommendations for life.
Since an incorrect lifestyle is a prerequisite and direct cause of pelvic varicose veins, its normalization will help to cure:
Treatment of pelvic varicose veins of any degree is not possible without drug support. In the first degree, it is the main treatment measure; in the second and third, it complements complex treatment.
The following drugs are used:
Additional groups of drugs are prescribed taking into account existing abnormalities in the body:
One of the effective means in the treatment of varicose veins in the area of the external genitalia and perineum is compression. The principle of this method is similar to the use of elastic bandages for varicose veins of the legs. External pressure (compression) of the superficial veins facilitates their emptying of blood. Special tights or shorts made of compression medical knitwear can create this effect. You can purchase them in specialized pharmacies, stores, and medical device stores, individually selecting the desired size and compression strength.
Sclerotherapy is a puncture of a varicose vein with the introduction of special drugs into the lumen (Sclerovein, Fibrovein, Aethoxysklerol), which cause it to stick together. This treatment is carried out for external (subcutaneous) pelvic varicose veins without hospitalization. Internal veins can also be sclerosed, but this procedure is technically more complex and takes place in an operating room.
Varicose veins of the pelvis are best treated surgically when:
The main types of operations for pelvic varicose veins:
If pelvic varicose veins are not treated at all, over time they expand even more (95%), which can lead to dangerous complications. In the remaining 5% - women with subcutaneous varicose veins of the perineum of 1-2 degrees, in whom it arose after childbirth, the pathology does not worsen, but will never go away on its own.
If you treat the disease, you can achieve complete recovery (10–50% depending on the degree) or significant improvement (45–50%), especially if surgical methods are combined with conservative ones. But in any case, after complex treatment, lifelong prevention should be carried out, consisting of following lifestyle recommendations, periodic medication or compression support for weakened veins.
How to choose a treatment method for varicose veins that is right for you? Read the article by a practicing phlebologist or request a free consultation by phone: +7 (499) 394-34-74.
Pelvic varicose veins (PVV) or chronic pelvic pain syndrome is still an exotic disease with unclear diagnostic boundaries for many doctors.
This explains the fact that some doctors “do not notice” this disease in their patients for a long time, while others make this diagnosis for almost every second person suffering from constant unexplained pain in the lower abdomen.
Meanwhile, the quality of the patient’s future life, his ability to enjoy the intimate side of relationships with a loved one and the opportunity to continue his family largely depend on the timely detection of pelvic vein varicose veins.
The phenomenon of chronic pelvic pain has been known to doctors for a long time. But only relatively recently has its most probable cause become known - varicose veins of the small pelvis. This disease was first described in 1975 and is still not well understood.
It is most likely that this pathology develops according to the following algorithm:
The leading symptom is pain, which is recorded in more than 90% of patients . But the prevalence of this disease among the population has not yet been clarified: according to various studies, it ranges from 6 to 80%. Such a large discrepancy in “indications” is explained only by the insufficient qualifications of diagnosticians when making a diagnosis.
The causes of pelvic varicose veins are any changes in the body that can trigger the launch of the pathological mechanism of this disease:
Increased risk factors for ARVMT are:
In the medical community, a conditional division of ARVMT according to the nature of the course is accepted into varicose veins of the perineum and external genitalia (for example, labia) and pelvic venous congestion syndrome. This classification does not have much practical significance, since in most cases both of these forms occur simultaneously in patients, as they provoke the appearance of each other.
You can also find a classification of the disease according to the root cause of its occurrence. In this regard, HRVMT is divided into:
There is also an attempt to classify this disease based on the severity of the pathology. In this regard, there are 3 stages of pelvic varicose veins:
This type of vascular pathology cannot be called a deadly disease . If detected in time, it lends itself well to medical correction. But the problem is that it is not so easy to detect. Insufficient knowledge of the disease and low awareness of most diagnosticians play a role in this.
So it turns out that patients suffer from this disease for years without even knowing it. Meanwhile, a number of irreversible changes occur in their body:
Typical symptoms of varicose veins and pelvic vessels that require visiting a doctor for treatment include:
Any of the above symptoms may be a reason to consult a doctor. You can’t hesitate in doing this , since it will take a lot of time to find out the true causes of discomfort and prescribe effective treatment.
According to American researchers, in the early 2000s, only 2% of patients with ARVMT were initially given the correct diagnosis. Sometimes the consequence of a diagnostic error was the removal of the reproductive organs in women, although this could have been avoided if the most accurate methods for diagnosing pelvic varicose veins :
When treating ARVMT, the following tasks are set:
Treatment of varicose veins of the pelvic vessels can simultaneously proceed in several directions, while surgical intervention is necessary only at stage 3 of the disease .
Varicose veins of the small pelvis are a disease of today.
Previously, when people led a more active lifestyle, such diseases were rare. Physical inactivity, working in an office at a computer, moving through transport - all this has led humanity to the need to solve new health problems.
Varicose veins of the pelvis are a disease associated with decreased elasticity of the venous wall. There are different names for this disease: varicocele (occurs in both men and women), varicose veins of the small pelvis, chronic pelvic algia syndrome.
The cause of this disease is often the backflow of blood into the pelvic vessels caused by compression by the enlarged uterus. This phenomenon often occurs during hormonal changes and during pregnancy.
Sometimes this type of varicose veins can begin during puberty, because then hormonal changes in the body also occur, but, unlike the course of the disease in adulthood, it occurs in the absence of symptoms, the only one of which may be an increased amount of discharge from the genitals.
Often with this disease, pain occurs in the lower abdomen when standing in an upright position; discomfort also occurs during physical activity and sexual intercourse. It is not uncommon for varicose veins of the pelvis to also cover the perineal area, vulva and gluteal region .
Among the causes of pelvic varicose veins, the most common are changes in the ratio of hormones in the body and pregnancy. Today, this disease can lead to:
The issue of pelvic varicose veins during pregnancy should be discussed in more detail.
The percentage of its manifestation during this period is far from low - varicose veins of the small pelvis occur in 30 percent of expectant mothers. Often pregnancy is a triggering event for pathology, and there are two reasons for this.
If you suspect varicose veins, treatment with folk remedies will be the best solution in the initial stages of the disease. Read more in our article.
What you need to know so that non-surgical treatment of varicose veins has the desired effect and does not lead to complications, read here.
The first is a sharp increase in the level of female hormones. The second reason is compression of the venous walls by the uterus, which rapidly increases during pregnancy, which in turn leads to the formation of collateral blood outflow pathways with the participation of the gonadal vein system in this process.
After childbirth, the pelvic veins go through a process of reverse involution, and the venous walls need to be restored.
Varicose veins of the pelvic organs have pronounced symptoms, the main ones are:
In different cases, all symptoms or some of them may be observed, and they can also be expressed to varying degrees.
Degrees of varicose veins of the pelvis.
There are three degrees of this disease, the measure of which is the width of the damaged veins in diameter and the location of the main disorders, venous ectasia:
The above classification was proposed by A. Volkov. Depending on the degree of development of the pathological process, certain treatment methods are selected - from lifestyle changes to surgical intervention.
In the first and second degrees, complete recovery is possible only with the help of so-called conservative treatment (use of venotonics, dietary changes, therapeutic exercises, use of anti-inflammatory drugs).
In the third degree, it is often impossible to do without surgical treatment methods, such as ligation and embolization of large veins, venectomy.
It is difficult to determine BP of the pelvic veins solely by analyzing patient complaints, because the symptoms are similar to many gynecological diseases. Thus, the following methods to more accurately diagnose this disease (carried out comprehensively):
The photo shows how pelvic varicose veins look during diagnostic examinations
Such methods are used to definitely exclude the presence of other diseases, and an accurately established diagnosis prevents the danger of incorrect treatment based on an inaccurate diagnosis.
When taking measures aimed at combating this disease, it should be remembered that the presence of varicose veins of the pelvic organs may be a signal of a predisposition to varicose processes, and accordingly adjust your lifestyle and lifestyle.
Taking into account the characteristics of this disease, the objectives of all treatment methods for pelvic varicose veins are as follows :
In accordance with these objectives, a number of actions have been developed aimed at treating this disease: special diets, therapeutic exercises, special medications, wearing compression underwear (stockings and tights of a specific design). In general, drug treatment combines the use of ointments for VR veins and venotonic drugs.
Other treatment methods are described in more detail below.
Conservative treatment for varicose veins of the small pelvis involves the gradual elimination of the symptoms of the disease by making adjustments to everyday life - establishing a balance between activity and rest, taking into account biorhythms, proper nutrition, the use of special types of physical activity and monitoring the time that the patient spends in an upright position.
Additionally, treatment with phleboprotectors (Detralex, Venoruton) and gestagen-containing substances is recommended. Recently, treatment with leeches ( hirudotherapy ), which are placed in the coccyx area, has been very popular.
Changing your diet involves eliminating foods high in saturated fats and alcoholic beverages. The preponderance in the diet should be in favor of foods high in fiber (vegetables, fruits, cereals), healthy fats (vegetable oils).
The diet for varicose veins completely excludes the consumption of spicy and very salty foods. Quitting nicotine use is also highly desirable.
The most recommended gymnastic exercise is a complex performed while lying down.
It includes such well-known exercises as “birch”, “bicycle” and “scissors”, in which the legs are actively developed, but the lumbar region is not overloaded.
Such exercises provide a rush of blood, which leads to the elimination of stagnant processes.
Surgical intervention is a last resort measure, which is used in cases where the disease is very advanced and there is a predisposition to varicose veins. Surgical intervention is selected depending on the location of the main disorders, and involves the following procedures:
If there is a need for surgical intervention, the selection of appropriate actions is very individual, since everything depends on the location of the lesion.
The best preventive measures for pelvic RV may be:
Criteria for the effectiveness of treatment of this disease include:
Effective treatment of pelvic varicose veins has a positive effect on both the physiological and psycho-emotional state of the patient.
Among the complications of varicose veins of the small pelvis, the following may occur:
women aged 25 to 45 turn to a specialist with similar symptoms and manifestations. During menopause, varicose veins of the pelvic veins are more complicated, and the likelihood of complications is higher.
Thus, the disease, being a consequence of the wrong lifestyle of a modern person, significantly affects its quality. Timely and adequate treatment can slow down the development or cure the disease completely.
That is why it is important to pay attention to the symptoms of this disease in time and consult a doctor.
Varicose veins of the pelvis in women are provoked by a phenomenon such as the reverse flow of blood through the ovarian vein, which occurs against the background of compression of blood vessels.
The trigger mechanism for the development of the disease is considered to be pregnancy, namely the hormonal changes observed during this period and the growing pressure of the uterus on the pelvic vessels.
This type of varicose veins is manifested by prolonged and intense pain in the lower abdomen, usually appearing after constant heavy physical exertion or before menstruation.
Why do varicose veins of the small pelvis occur, and what is it? In most cases, this disease is diagnosed in women, and most often this disease is found in patients aged 25 to 45 years.
Quite often, such patients first try to cure varicose veins on their own - folk remedies that are used without prescription and consultation with a specialist can lead to unwanted side effects, so you still have to contact a phlebologist.
Factors that provoke the development of this disease include:
Varicose veins in the pelvis are very similar to varicose veins in the legs. In both cases, the valves in the veins that help blood flow to the heart are affected. The function of the valves to prevent backflow of blood is impaired. When the valves collapse, blood stagnates in the veins. Veins that become engorged with blood stretch and further increase congestion. Pelvic venous congestion syndrome develops mainly near the uterus, fallopian tubes, vulva and even vagina.
A number of symptoms may indicate the presence of pelvic varicose veins in women. The most important of them are causeless pain in the lower abdomen, pelvic area, often radiating to the lumbar region or perineum. Also, a woman may be bothered by copious mucous discharge from the genitals, especially in the second half of the menstrual cycle.
In addition to the main ones, there are also other, no less important symptoms of varicose veins of the pelvic organs in women:
If you encounter these symptoms, you should immediately consult a specialist. Since this disease can have many unpleasant consequences:
It is also worth noting that the above symptoms can be expressed in different ways (weaker or stronger); some women have all the signs of the disease, while others have 1-2 of them.
To make a correct diagnosis, a woman undergoes a full comprehensive examination.
When a patient complains of pain arising for an unknown reason, the doctor first determines all the factors that caused the pain syndrome. The patient's legs are carefully examined. This way you can detect the appearance of varicose veins. In special cases, a consultation with a vascular doctor is carried out.
The use of such methods makes it possible to more accurately determine the symptoms of the disease.
To standardize diagnosis and attempt a differential approach to treatment, A.E. Volkov classified pelvic varicose veins depending on the diameter of the dilated vessels and the localization of venous ectasia.
There are 3 degrees of this disease:
Depending on the severity of the pathological process in the pelvis, it is possible to use conservative treatment methods and surgical interventions.
If a woman has been diagnosed with pelvic varicose veins, treatment is aimed at achieving the following goals:
ARVMT therapy includes two main components:
For varicose veins of the pelvic veins of 1st or 2nd degree, as a rule, conservative treatment methods are used (venotonics, nonspecific anti-inflammatory drugs, physical therapy). Conservative treatment for pelvic venous congestion syndrome is symptomatic, including normalization of working and rest conditions with the exception of significant physical activity and prolonged stay in an upright position.
It is worth understanding that even the highest quality treatment does not make it possible to completely cure varicose veins of the small pelvis. But, nevertheless, adequate therapy allows you to get rid of most of the clinical manifestations and significantly improve the patient’s condition.
Due to the internal location of the veins affected by the disease, medications are prescribed orally; it is not possible to use venous gels and ointments. The following means are used:
Experts recommend combining drug therapy with physical therapy and wearing special compression garments. There is a special need for compression garments during pregnancy.
Surgery is a last resort measure, which is used in cases where the disease is very advanced and there is a predisposition to varicose veins. Surgical intervention is selected depending on the location of the main disorders, and involves the following procedures:
If there is a need for surgical intervention, the selection of appropriate actions is very individual, since everything depends on the location of the varicose veins.
Physical therapy for pelvic varicose veins consists of the following exercises:
The exercises can be done anywhere. If you wish, you can replace, add or remove any exercises, the main thing is to make sure that the body does not overexert itself. Therapeutic exercise must be combined with wearing compression stockings.
The most popular and famous folk remedies:
Diet also plays a significant role in the treatment of varicose veins - nutrition should be balanced and contain a sufficient amount of animal proteins and plant fiber.
Also follow a few simple recommendations that will not only serve as a preventive measure for ARVMT, but will also improve the general condition of the body:
The most common complications of this disease are:
In conditions of impaired venous outflow, there is a risk of developing pelvic vein thrombosis. But the frequency of this type of complications does not exceed 3-5%.
Pelvic varicose veins (PVVV) is a fairly common disease, especially in women. But due to the ignorance of many doctors about the features of this disease, the diagnosis is rarely made, and the diagnosis of the disease is considered almost “clinically exotic.” Due to the variety of symptoms and the dominance of pain syndrome, ARVMT is often disguised as gynecological inflammatory and hormonal diseases, pathology of the urinary system (cystitis), surgical diseases (colitis and Crohn's disease), lumbar radiculitis and even diseases of the hip joint.
The frequency of ARVMT is 5.4 – 80%; such a wide range is due to the ambiguity of diagnosis and treatment principles. The incidence of this pathology increases with age; in teenage girls (under 17) the percentage of the disease reaches 19.4, while in perimenopause the prevalence of ARTVMT increases to 80%. Most often, URVMT is diagnosed in women of childbearing age.
It should be noted that this pathology often occurs during pregnancy; in approximately 30% of expectant mothers, the disease is diagnosed after the 8th week of gestation.
Most women know about the existence of such a disease as varicose veins of the lower extremities. Unlike ARVMT, varicose veins of the legs can be seen, since dilated veins, as a rule, are located under the skin (there is also an expansion of deep veins) and are clearly visible.
Varicose veins of the small pelvis are the pathology of veins located deep in the pelvis; accordingly, they are not visible to the eye, and it is difficult to suspect the disease. With ARVMT, the architectonics (structure of the venous wall) of the veins is disrupted, their elasticity decreases, as a result of which venous blood stagnates in the pelvis. In other words, the pelvic veins become clogged, swollen, and the outflow of venous blood is disrupted, which leads to venous congestion.
VRVT is also called pelvic venous congestion syndrome. In some sources you can find the term “varicocele in women,” which is not entirely correct. With varicocele, the process involves the veins of the spermatic cord and testicle, which are present only in men, but according to the mechanism of development and symptoms, the disease is similar to VRVT.
Also, a number of authors call ARVMT a syndrome of chronic pelvic pain, which is also incorrect. This syndrome can be caused by many reasons (gynecological, urological diseases), including varicose veins of the pelvic veins.
To date, it has been proven that URVMT is caused by the expansion of the ovarian plexus of veins and veins of the broad uterine ligament. And the mechanism for the development of the pathology lies in the insufficiency of the valves of the ovarian veins, which leads to the return of blood (reflux) and provokes an increase in venous pressure and the development of venous stagnation in the plexuses of the pelvic veins. Against the background of impaired venous blood flow, collateral (additional) blood circulation pathways develop in the main veins.
Also, the level of hormones, in particular the level of progesterone, plays an important role in the development of the disease. Progesterone, a pregnancy hormone, reduces the tone of the smooth muscles of not only the uterus (preventing miscarriage), but also the vascular wall, which causes their dilatation (expansion) and venous stagnation. In addition, as pregnancy progresses, the growing uterus begins to compress large vessels of the retroperitoneal space (inferior vena cava and iliac vein), which stimulates the formation of collaterals. Therefore, IDU is much more common in expectant mothers than in all other women.
The hormonal theory of pathology development is confirmed by the detection of ARVMT in girls of puberty, when hormonal surges associated with puberty are noted. Of all the signs of pelvic varicose veins in girls, only one is noted - an increase in vaginal leucorrhoea.
Another trigger for the development of pathology is connective tissue dysplasia, which occurs in approximately 35% of people. Against the background of dysplasia, a lack of collagen is found in the vascular wall, which ensures the elasticity and strength of blood vessels. In extreme cases, there may be no collagen at all. Systemic damage to connective tissue explains the frequent combination of pelvic varicose veins with varicose veins of the legs and hemorrhoids.
The following factors predispose to the development of ARVMT:
Increased blood volume in the vessels, increased progesterone content, and a growing uterus - all this leads to dilatation of the pelvic veins and compression of the great vessels.
Reduced vascular tone and underdevelopment of venous valves lead to increased tortuosity and fragility of the veins.
Increases the load on the female body, including the blood vessels, several times.
Prolonged labor or childbirth with a large fetus, anomalies of labor forces, as well as a large number of births contribute to disruption of blood flow in the pelvic veins, in the veins of the lower extremities and hemorrhoidal plexuses.
Both “sedentary” and “standing” work, due to constantly occurring physical inactivity, cause venous stagnation.
This group includes inflammatory diseases of the uterus/appendages, tumors (fibroids, cysts and ovarian neoplasms) and endometriosis.
The posterior bending of the uterus causes a bend in the broad uterine ligament, which disrupts the venous blood flow in it, and then in the veins of the pelvis.
The effect of hormone replacement therapy and COCs is confirmed by the following fact: in postmenopause, the severity of the manifestations of ARVMT decreases.
With anorgasmia (lack of sexual satisfaction), blood stagnation occurs in the pelvis, which over time transforms from sexual frustration into varicose veins of the pelvic veins. Venous congestion also provokes dyspareunia (pain during and after sexual intercourse). Interrupted sexual intercourse also has an adverse effect on the venous blood flow of the pelvis. Women whose partners adhere to this method of contraception are more likely to experience ARVMT (due to the same anorgasmia).
Depending on the clinical manifestation, there are 2 forms of pelvic vein varicose veins:
Both forms exist simultaneously, only the symptoms of one of them are more pronounced. A vicious circle is formed - dilated vulvar veins lead to disruption of venous outflow in the pelvis, and dilatation of the pelvic venous plexuses causes dilation of the vulvar veins.
Expectant mothers more often experience dilation of the veins of the vulva; the pathology may disappear on its own after delivery, but persists in 2–10% of cases.
Classification by A. Volkov (according to the degree of venous expansion):
Symptoms of varicose veins of the small pelvis in women are very diverse and are often disguised as diseases of adjacent systems and organs. As already indicated, the disease can occur with a predominance of manifestations of one or another clinical form.
The main sign of this form is a clear expansion of the veins in the area of the vulva and/or perineum, which the woman herself sees. A woman complains of itching and discomfort of the vulva, a feeling of heaviness or bursting pain in this area. A gynecological examination reveals swelling and swelling of the labia, enlarged and dilated veins on their surface, in the perineum and buttocks, and in most cases hemorrhoids.
There is a high probability of either spontaneous or post-traumatic bleeding (after coitus or childbirth). Since the venous wall is significantly thinned, it is quite difficult to perform hemostasis (stopping bleeding) even using surgical methods (ligation of damaged veins or clamping them).
A complication of this form is acute thrombophlebitis of the perineal veins. In this case, very severe pain appears, the skin of the perineum turns red and swells. The veins at the site of thrombosis thicken and become painful. Venous thrombosis is accompanied by inflammation (phlebitis), which is accompanied by an increase in temperature (up to 38 degrees) and intoxication syndrome (weakness, loss of appetite).
Pain syndrome comes first in this form. What pain occurs with varicose veins of the small pelvis? The nature of the pain is constant, it is localized in the lower abdomen and has varying intensity and character (pulling, aching, dull, bursting, moderately or significantly pronounced).
The pain can radiate to the lumbar and sacral area, to the perineum or to the groin. A characteristic feature of pain in pelvic venous congestion is that it intensifies after prolonged exposure to a stationary position (sitting or standing), as well as after performing physical work and lifting heavy objects.
The disease is also characterized by dyspareunia, and pain can appear both during and after sexual intercourse. Dyspareunia provokes the development of vaginismus and fear of coitus. There is increased sensitivity (hyperesthesia) of the skin of the perineum and vaginal mucosa.
Another sign of this form is premenstrual syndrome, the manifestations of which are pronounced, and increased pain occurs in the second phase of the cycle (starting from day 14).
Painful menstruation and cycle disorders (dysmenorrhea), and an increase in the volume of vaginal discharge also occur.
In some cases, there are urinary disorders (painful and frequent), which is associated with venous congestion of the bladder.
Violation of the usual way of life, sexual dissatisfaction, and constant family conflicts worsen the psycho-emotional state of a woman and lead to the development of neuroses and depression.
Diagnosis of pelvic varicose veins is very complex and should be carried out with the participation of a gynecologist and phlebologist. All diagnostic measures are divided into Non-invasive and invasive.
It is carried out without fail, but only allows one to suspect varicose veins of the small pelvis. An external examination reveals thickened and dilated veins on the labia, perineum and inner thighs. Examination in a gynecological speculum allows one to see cyanosis (blueness) of the vaginal walls, and palpation reveals pastiness (smoothness) and pain in the vaginal vaults. Pain also occurs when palpating the appendages, uterine ligaments, and when displaced behind the cervix.
It is preferable to perform a combined ultrasound simultaneously with transabdominal (through the abdominal wall) and transvaginal (through the vagina) sensors using Doppler ultrasound. This study allows us to identify not only the organic pathology of the uterus and appendages, but also to “see” conglomerates of varicose veins, assess the blood flow in them and its speed, and determine pathological reflux.
These diagnostic methods make it possible to exclude organic pathology of the pelvic organs and confirm the presence of varicose conglomerates in the uterus, its broad ligament and in the ovaries.
The gold standard for vascular examination is an X-ray examination with the introduction of a contrast agent (angiography):
Injection of contrast into the uterine muscle in the area of its fundus via the intracervical route, followed by X-ray examination.
Contrast is injected into the ovarian veins.
It is performed for vulvar and perineal varicose veins; contrast is injected into the veins of the perineum.
It is carried out for differential diagnosis and identification of concomitant diseases that complicate the course of ARVMT. In some cases, diagnostic laparoscopy turns into therapeutic laparoscopy - the veins of the ovaries are ligated.
Treatment of ARVMT should be comprehensive and include basic therapy, medication, and, if indicated, surgical intervention.
The basis of any treatment is a regimen and proper nutrition. First of all, patients with ARVMT should resolve the issue of working conditions. If possible, the employee is transferred to a job that excludes heavy lifting and significant physical activity. In the case of sedentary or standing work, you should take short breaks every 30 minutes and perform simple exercises (walking in place, squatting, raising your knees high). The same principle should be followed in your free time.
It is also necessary to reconsider nutrition. Refractory fats (lard, fatty meats), spicy foods, seasonings, marinades, smoked meats and pickles, alcoholic beverages, and smoking should be excluded from the diet. Diversify the menu with a large number of fresh vegetables and fruits, vegetable oils (a source of vitamin E - an antioxidant), and cereals.
Patients with varicose veins of the pelvic veins are recommended to wear compression underwear - stockings or tights, which normalize blood flow in the vessels and eliminate venous congestion.
In addition, patients with ARVMT need to do gymnastics daily, doing:
To prevent relapses, swimming, jogging, and cycling are recommended.
A daily contrast shower of the inner thighs, perineum and lower abdomen is useful.
Pharmacological drugs for this disease are prescribed in courses and include the following pharmacological groups:
Phlebotonics and phleboprotectors recommended for use:
Surgical treatment of varicose veins of the pelvis is carried out according to strict indications:
Various surgical techniques are used depending on the location of reflux and venous conglomerates:
Is it possible to use traditional methods of treatment for varicose veins of the pelvic veins?
Yes, the use of traditional methods of treatment is allowed as an additional therapy to drug and basic treatment. Taking infusions of horse chestnut, birch mushroom (chaga) and dandelion root is effective.
What are the dangers of this disease?
Possible complications and consequences of ARVMT include: menstrual irregularities in the form of dysfunctional uterine bleeding, inflammation of the uterus, appendages and urinary tract. There is also a high risk of such a serious complication as pelvic vein thrombosis, which requires immediate surgery and infertility.
I have significantly dilated veins in the vulva and perineum, I am 34 weeks pregnant with twins. How will I give birth?
Considering multiple pregnancies and pronounced varicose veins, the doctor will most likely suggest a planned cesarean section, since the risk of possible damage to the veins during spontaneous childbirth and bleeding is very high.
Is it possible to treat pelvic varicose veins with leeches?
Yes, hirudotherapy is widely used for varicose veins of both the lower extremities and pelvic veins. Leeches for ARVMT are placed on the skin of the sacrum.