Treatment of varicose veins in the small pelvis in women

Pelvic varicose veins are a relatively new condition that doctors didn't learn about until the advent of diagnostic ultrasound in the late twentieth century. This is one of the most common causes of chronic abdominal pain. In addition, pelvic varicose veins can cause dangerous complications: thrombosis, thrombophlebitis, pulmonary embolism.

What are pelvic varicose veins?

The essence of the pathology is that veins dilate, fill with blood, and become overstretched. The fluid portion of the blood leaks through the blood vessel walls, causing tissue swelling.

Causes of pelvic vein dilation

Three main mechanisms of minor pelvic varicose veins have been established:

• Pelvic venous valve insufficiency - they are supposed to allow blood to flow only toward the heart, but if the valve mechanism fails, some blood can back up;
• Pelvic blood vessel obstruction (blockage, blockage);
• Hormonal changes in women increase the permeability of vein walls.

Some women have underdeveloped valves or are born without them. It has been established that genetics play an important role in the development of small pelvic varicose veins. 50% of women have a heavy family history: a close relative has a case of pelvic varicose veins. Several genes related to the development of uterine varices have been identified: FOXC2, TIE2, NOTCH3. Their mutations can lead to weakened vein walls or valve failure.Pregnancy may trigger the development of varicose veins in the small pelvis. Pregnant women's hormone levels change and the amount of blood circulating in the body increases by 30%. Additionally, the volume of the pelvic veins increases by 60% due to mechanical compression of the veins by the enlarging uterus and increased progesterone production. Blood vessels remain dilated throughout pregnancy and for a month after delivery.In addition to uterine compression, other risk factors include:

• Endometriosis;
• Sitting or standing for long periods of time (resulting in stagnant blood flow to the pelvic organs);
• Innate structural characteristics of blood vessels.

In 3% of women, the direct cause of the disease is May-Turner syndrome. This is compression of the left common iliac vein by the right common iliac artery.

Symptoms of pelvic venous dilation

Pelvic varicose veins are associated with the following syndromes:

• Varicose vein syndrome.It manifests as marked dilation of the vulvar and perineal blood vessels. In addition, some women develop enlarged veins in their buttocks, pubic bone, and groin. The labia may become swollen at the end of the day.
• Pain syndrome.Varicose veins in the small pelvis have dilated blood vessels, which become a major reason to see a doctor and undergo treatment. Pain Characteristics: Persistent, painful, located in the lower abdomen (related to the uterus) and radiating to the thighs and perineum. The pain worsens with physical activity and when the body is still for long periods of time. They decrease after resting in a horizontal position. Pain may worsen during the second phase of the menstrual cycle, which is related to hormonal changes.
• Pelvic organ dysfunction.Most commonly, the menstrual cycle is disrupted due to pelvic varicose veins. The second most common syndrome in this group is dyspareunia. This is pain that occurs during or after sexual intercourse. They are associated with overflow of blood from the venous beds of the pelvic organs. Pain may last from half an hour to a day after exposure. The third most common symptom is difficulty urinating. There is usually increased urination and, rarely, urinary incontinence.
• Psycho-emotional disorders.They are caused by long-term pain and reduced quality of sexual life. Depression occurs in most cases.

A characteristic feature of varicose veins is that the severity of symptoms is not directly related to the diameter of the dilated blood vessels. That is, symptoms may not be present in severe forms of the pathology, and vice versa: symptoms may be very noticeable even in the initial stages.

Diagnosis of varicose veins

The main diagnostic method is ultrasonography. It is performed transabdominally (through the abdomen) and transvaginally (through the vagina). Different methods allow you to see different ships.Modern ultrasound options: Color mapping and power Doppler can improve the effectiveness of diagnosing varicose veins.

• X-ray contrast - pelvic venography and selective ovaryography.
• CT and MR venography are diagnostic methods that provide more information than traditional X-rays. In addition, they are less invasive: Contrast material can be injected into the cubital vein, and MRI can provide a wealth of information even without the use of contrast material.
• Radionuclide technology.

Conservative treatment of varicose veins

If there is no indication for surgical removal of pelvic veins, conservative treatment is the main approach. Additionally, it can complement surgery. Varicose veins are not a local disease, but a systemic disease. Veins elsewhere (if they are not already dilated) may become dilated, most commonly in the legs. Medications and surgery can increase the tension in the vein walls and slow the progression of varicose veins.

• Medications to treat varicose veins in the small pelvis;
• compression jersey;
• Herbal medicines (most medications for treating small pelvic varicose veins are plant-based);
• physiotherapy;
• physiotherapy.

The main way to treat varicose veins is to take medications. All other methods are only auxiliary.These drugs are effective primarily because they affect veins throughout the body, not just the pelvis. They increase the tone and reduce the permeability of blood vessel walls. Most commonly, diosmin preparations are used to treat varicose veins. Depending on the indication, hormonal drugs are included in the treatment regimen. For symptomatic treatment, nonsteroidal anti-inflammatory drugs are prescribed - they reduce pain. Many patients require antidepressant medication.Compression therapy is most commonly used to treat varicose veins in the legs. It is rarely used when the pelvic veins are affected. If when the veins of the legs are affected, compression stockings or stockings are used, squeezing the lower parts of the limbs, then when there are varicose veins in the small pelvis, on the contrary, compression is needed on the upper parts. Compression shorts are used to compress the upper third of the thighs, pelvic area, and anterior abdominal wall. Please note that the effectiveness of this method has not been proven and does not provide long-term results: it can only be used for symptomatic purposes.

Surgical treatment of pelvic venous dilatation

Invasive surgeries and surgeries can help eliminate the manifestations of pelvic varicose veins and reduce the risk of complications. Depending on the characteristics of the disease, they are carried out on different blood vessels of the pelvis.

Intervention on perineal blood vessels

Phlebectomy is used to remove veins from the perineum and buttocks. This is a minimally invasive intervention that involves removing the vein through minimal incisions. It has obvious advantages: fast recovery, low risk of complications, and good aesthetic results.But venous resection is not always possible. Not suitable for eliminating varicose veins in the labia majora and minora. The vein must be removed through a longer incision. If the labia minora has varicose veins, the labia minora may need to be removed and plastic surgery performed.Minimally invasive procedures are also used: sclero-occlusion of the vulvar and perineal veins. The doctor injects a liquid or foam sclerosant into the vein. As a result, these veins stick together, become invisible, and the blood flowing through them stops flowing.These blood vessel dilation treatments are highly effective: 95% of patients are satisfied with the results. The disadvantage is the high recurrence rate - the recurrence rate is as high as 60% within 7 years after sclerotherapy, and the recurrence rate is as high as 40% within 7 years after surgical removal of dilated veins. To reduce the risk of recurrence, doctors must eliminate pelvic subcutaneous venous reflux during treatment.

Intervention on gonadal vessels

The goal of treating varicose veins is to eliminate retrograde (backwards) blood flow in the ovarian vessels. As a result, the blood supply to the pelvic venous plexus is reduced. These interventions are considered the most effective.The surgical technique to remove varicose veins is simple and less invasive. Trauma is further reduced using endoscopic techniques - in this case, the surgery is performed through the smallest incision. Surgical methods are also very effective. Chronic pelvic pain after phlebectomy resolves in 100% of patients within 1-2 months postoperatively. The risk of recurrence within 5 years of observation is no more than 3%. It can be done without surgery. Embolization is used for treatment. A sclerosing (adhesive) drug or coil is introduced through the blood vessels into the ovarian veins, causing blood clots to form, eliminating the dilation and completely closing the veins. According to various authors, the method is 65-95% effective. Although not as effective as surgical phlebectomy, it has the advantage of being minimally invasive, which is why endovascular surgery is one of the standard methods of treating pelvic varicose veins in women.

Interventions in the kidneys and iliac vessels

Limited use. Clinical situations requiring these types of interventions are uncommon.Left renal vein surgery in women is performed with compression, which can lead to increased pressure. The doctor moves the vein and creates a new anastomosis (connection) between the left kidney and the inferior vena cava. He also underwent ovarian vein resection.Left iliac vein surgery is used to treat May-Turner syndrome. Doctors perform endovascular stenting (installing a frame inside the vein) of the left common iliac vein. This is a rare surgery and is only performed in specialized centers.

where to

To treat varicose veins, contact SOYUZ Clinic. We perform minimally invasive surgery. Interventions are performed by experienced doctors using the latest equipment. All women experience pelvic pain after surgery.

Causes of pelvic varicose veins

The most common risk factors for varicose veins are:

• Sedentary, sedentary lifestyle;
• "Aorto-mesenteric forceps" syndrome;
• pregnancy and delivery history;
• genetic susceptibility;
• Congenital anatomical features of the renal vein;
• Endometriosis;
• Injuries to the pelvic area, etc.

Treatment of varicose veins in the small pelvis in women

Pelvic varicose veins are a relatively new condition that doctors didn't learn about until the advent of diagnostic ultrasound in the late twentieth century. This is one of the most common causes of chronic abdominal pain. In addition, pelvic varicose veins can cause dangerous complications: thrombosis, thrombophlebitis, pulmonary embolism.

Causes of pelvic varicose veins

According to international research, almost one in three women suffers from chronic pelvic pain. The causes of chronic pelvic pain vary, but are often related to ovarian pathology or small pelvic varicose veins. The symptoms of pelvic venous stasis are similar to those of varicose veins in the legs. In both cases, the valves in the veins that help blood return to the heart against gravity become weak and fail to close properly. This allows blood to back up through the ovarian veins, which increases venous pressure and leads to varicose veins. The flow of blood is disrupted by similar mechanisms as in varicose veins in the legs. Due to insufficiency of the venous valves, the dilated ovarian veins do not have the ability to regulate the reverse flow of venous blood. Overcrowding of the venous system leads to stretching of the vein walls and secondary dilation of the pelvic vessels, and thus the disease progresses.Because the causes of pelvic pain often go undiagnosed, no treatment is offered, although treatments do exist. If you have pelvic pain that may worsen during the day when you stand upright, you may want to seek a second opinion from a vascular surgeon to help find the cause of the problem. Pelvic varicose veins can be effectively treated using endovascular surgical methods. Gynecology does not offer effective treatments for this disease.

Clinical treatment of small pelvic varicose veins

As part of conservative treatment, your doctor will prescribe anticoagulants, vetotonics, and vitamins. Efforts are aimed at lowering blood cholesterol levels and correcting the woman's lifestyle. If surgical intervention is required, minimally invasive techniques are best used.Sometimes, the pathology involved may be the reason for the inability to conceive or cause problems during pregnancy. No matter where you are in life with reproductive health issues, experienced gynecologists and obstetricians and gynecologists are here to help you cope. The clinic creates the most favorable conditions and provides effective treatments for the health of women and their families.

With the help of special instruments, special spirals are installed into the venous cavities to prevent improper blood flow, which can lead to pelvic varicose veins

No stitches required. The duration of the procedure ranges from 30 minutes to several hours, depending on the complexity of the condition.Symptoms of pelvic varicose veins include:

• pelvic discomfort
• heaviness in pelvis
• Pain in the pelvis

These symptoms may worsen with prolonged standing and sitting during menstruation and sexual intercourse. Cause discomfort and pain to women.Pelvic varicose veins (PVVV) develop due to weak connective tissue. But the occurrence of the disease requires the presence of predisposing factors.These factors are:

• Physical exercise
• standing and sitting for long periods of time
• pregnancy and childbirth
• Pelvic trauma
• Uterine and ovarian tumors
• endometriosis
• Indications for embolization therapy are:
• Pelvic varicose veins and chronic pelvic pain syndrome
• Dysmenorrhea
• External genital varicose veins
• pain during intercourse

Pelvic varicose veins come in both symptomatic and asymptomatic forms (that is, they can occur without symptoms). The asymptomatic form usually does not require any treatment

Symptoms of pelvic varicose veins in men and women

Visual symptoms are minimal. During examination, superficial venous dilation in the perineal and buttockal areas is rarely noted. Urinary disturbance due to congestion of the vesical venous plexus.The disease is accompanied by internal sensations. The patient complained of dull pain in the lower abdomen and inner thigh. There is a heavy, swollen feeling. Men and women may complain of varying degrees of pain in the lower abdomen during intercourse.Chronic pelvic pain:

• Persistent dull pain in lower abdomen;
• Pain in the sacrum and coccyx area;
• lower back and groin pain;
• Frequent urination;
• urinary incontinence;
• False urge to empty the bladder.

Dilated veins in the external genitalia (perineum, lower abdomen, suprapubic bone, inguinal area, back of thighs, buttocks).The veins on the inner thigh are enlarged.

Pelvic varicose veins and their treatment

Painful varicose veins in the small pelvis are more common in women. The disease is common, but diagnosing it is a complex process. Many more women walk around with abdominal pain throughout their lives and treat an imaginary pathological process without even thinking that they have small pelvic varicose veins.

What are pelvic varicose veins?

Pelvic varicose veins (PVVV) is a disease that affects the elasticity of blood vessels. Medically, the disease has different names: varicocele (in both men and women), small pelvic varicose veins, chronic pelvic pain syndrome.Women of childbearing age often suffer from this disease, and timely treatment is very important.

What are pelvic varicose veins

Varicose veins in the small pelvis are dilations of blood vessels that drain blood from the genitals. With this disease, veins can dilate to more than ten millimeters in diameter, causing nerve endings to become compressed and painful. vienna

Why do pelvic varicose veins occur?

The causes of minor pelvic varicose veins in women are thought to be:

• The growing uterus during pregnancy puts pressure on blood vessels;
• weightlifting and other physical activities;
• Sedentary jobs, sedentary lifestyles;
• Gynecological diseases: ovarian inflammation, endometriosis;
• Erratic menstrual cycle;
• Hormonal imbalances and treatment with estrogen-containing medications;
• Congenital anomalies of blood vessel walls;
• Lack of orgasm or protection from frequent interruptions in intercourse.

Types of minor pelvic varicose veins

Phlebologists distinguish between two types of small pelvic varicose veins:

• Primary, caused by congenital or acquired dyspareunia
• Advanced varicose veins in the small pelvis can cause symptoms such as swollen veins in the groin, thighs, and buttocks. Manual examination may also reveal venous nodules.

Thromboembolic processes may be a complication of small pelvic varices.The first stage of varicose veins is characterized by veins up to 5-7 mm in diameter located at the upper edge of the left ovary. In the second stage, veins (up to 8-9 mm in diameter) occupy the entire left ovary, and veins are also observed in the right ovary and uterus. In the third stage, veins with a diameter of 10-13 mm were found below the lower edge of the left ovary, and varicose veins were obvious in the right ovary, uterus and small pelvis. Moreover, by the third stage, the vein diameters of the left and right ovaries are almost the same.

Treatment of varicose veins

Treatment options depend on how advanced the varicose veins are. Doctors insist on conservative and gentle treatment: maximum results with minimal intervention on the body. And, while the disease can be treated without surgery, medications, injections, and vitamins are available to reduce pain and other manifestations of pelvic varicose vein symptoms. It also normalizes blood flow and eliminates risk factors for blood vessel obstruction. Doctors accurately calculate the dosage of drugs for each case to help the body cope with the disease almost independently.Normal working conditions are strictly adhered to, except for heavy physical exertion and prolonged stay in one position. rest. This improves the patient's quality of life: physical and social activities increase, and the psychological state returns to normal.It is recommended to correct the nature of the diet; increase fiber content in the diet and consume moderate amounts of vegetables, fruits and vegetable oils. 80% of fatty and spicy foods are excluded from the diet, and alcohol is completely eliminated. For overweight people, weight correction is recommended to reduce the pressure on the intra-abdominal organs and venous system.The phlebologist may also recommend quitting smoking and taking hormonal contraceptives to reduce the effects of estrogen and progesterone on the body. Because these hormones reduce the tension and elasticity of blood vessel walls.Contrast showers are recommended in the perineal area. Breathing Exercises: Use your abdominal muscles to inhale and exhale slowly and deeply. water program. Various unloading exercises. We strongly advise against self-medicating without consulting a phlebologist. Each patient needs to individually choose a treatment plan that includes a specific set of physical exercises.Treatment options include wearing compression stockings: tights or shorts with a specific level of compression suited to the specific condition. Wearing compression stockings can improve blood flow to the lower extremities, including the venous plexuses of the perineum and buttocks. On average, wear time is up to 14 days: a few hours a day. You will learn how to choose a size, compression level and manufacturer from the compression stockings article, or your phlebologist will provide complete information during your consultation.Phlebologists prescribe nonsteroidal anti-inflammatory drugs and painkillers when patients complain of often excruciating pain in the pelvic area. Use must follow doctor's advice.If conservative treatments are ineffective or the disease is advanced, a phlebologist may prescribe sclerotherapy or phlebectomy (surgical intervention) to remove the affected veins. The procedure is absolutely painless and is performed under anesthesia. Many patients worry about pain during and after surgery and are surprised that it completely disappears. So, don’t be afraid, the painlessness is proven by doctors’ years of experience. You can go home the day after surgery.Without timely and appropriate treatment, patients experience worsening of symptoms and quality of life. For women: Inability to get pregnant and give birth on their own. For men: heaviness and inability to lead an active lifestyle.With conservative treatment, patients can gradually recover during the treatment process. After surgery, patients recover easily and quickly. You will be able to walk independently the day after surgery.

Measures to prevent varicose veins in the small pelvis

Prevention aims to eliminate disease risks and symptoms. Here are some simple steps to help you:

• Moderate physical activity: walking, exercising. Moving muscles keeps blood flowing in your veins, which is why exercise is important.
• If you need to sit or stand at work, try taking a break every 30 minutes to move around. For example, take a walk, put on the kettle, carry something to the shelf.
• Women are advised to avoid strenuous and excessive physical activities: swings, lifting weights and overcoming incredible distances. Such a load is unnatural for the female body.
• Stick to your drinking habits. Adults need 30ml per 1kg per day.
• Eat well and drink well. Eat more vegetables and fruits. Eat less fast food, greasy, floury and spicy foods.
• Consult a phlebologist and perform a series of exercises at home.