Varicose veins are a disease associated with an increase in the length of the veins, the development of serpentine-like pathological curvature of the veins, irreversible pituitary enlargement of the lumen, and valvular failure. The organs of the lower pelvis are involved in the process of varicose veins. The mechanism of the disease is different. Doctors list the perineal region, the external and internal genitals as an atypical localization.
General information on pathology
The process of blood flow through the veins takes place in such a way that, under physiological conditions, preconditions are created for stagnation and the outflow of blood.
Varicose veins (VV) - dilatation of the external genitalia. The disease occurs in women who suffer from pelvic and leg varicose veins and in pregnant women. In 30% of cases, pelvic varicose veins affect the perineum and vulva.
The onset of treatment for the disease is delayed due to its location in an intimate location. Women are shy. In some cases, patients do not experience pain or discomfort. But varicose veins during pregnancy, and not just when carrying a fetus, have complications: thromboembolic vein blockage (thromboembolism), sexual sensitivity disorders, perineum pain, psycho-emotional problems, and family conflicts.
The mechanisms of pelvic vascular congestion have not been fully elucidated. The cause of the primary form of the disease is called failure of the valves in the veins of the gonads (ovaries). This causes blood to flow back and increases the pressure at the venous nodes in the lower pelvis. Insufficient valves may be acquired or congenital. It gets worse with age or pregnancy.
The secondary form of VVV in the pelvic organs is associated with gynecological pathologies: endometriosis, tumors of the pelvic organs.
Diagnosis of the disease is difficult because there are no specific symptoms of its course. It is based on the results of ultrasound (ultrasound).
To distinguish between primary and secondary forms of pathology, the Valsalva test is used in the sonographic examination. Negative in the secondary cause of pelvic varicose veins.
Varicose veins of the labia with VBT
A medical examination is required to establish a diagnosis of varicose veins. The symptoms of the disease are as follows:
- varicose veins in the genitals;
- pain in the external genitalia;
- difficulty and burning sensation in the perineum;
- swelling of the perineum by the end of the day.
Chronic pelvic pain is less common (30% of cases).
Once the diagnosis is made, an examination is performed to determine the degree of complexity of the pathological process and to prescribe appropriate treatment. There are several events:
- examination of perineum and leg veins using ultrasound angioscanning - USAS;
- ultrasound examination of pelvic vessels, including vaginal, uterine, parametric, ovarian, hip, inferior vena cava, and renal veins;
- multispiral computed tomography (MSCT), selective ovarycography, and pelvic phlebography (SOFT) are indicated.
Doctors call a characteristic feature of varicose veins with VBT that the disease is constantly evolving and is combined with the transformation of intravenous veins.
Treatment of vulvar varicose veins with lower pelvic varicose veins
IV treatment is prescribed based on symptoms and diagnostic results.
Non-steroidal anti-inflammatory and phlebotropic drugs are prescribed in complex drug therapy for the treatment of systemic chronic venous pathology.
Prescribing pharmacotherapy with antiplatelet agents, intramedullary blockade with antihypoxans, physiotherapy with ultrasound, therapeutic practices. Antioxidants and enterobiotics are added to the therapy.
Phlebosclerotic treatment is indicated - sclerotherapy. The container is "sealed" with drugs and a laser. It stops working. The procedure does not use special anesthesia methods. It is performed on an outpatient basis and has a cosmetic effect.
Surgical removal of the veins is recommended for multiple pelvic veins, dilation of blood, and recurrence of gonadal (ovarian) veins. It is removed in case of varicose veins.
The pubic body returns during pregnancy
Pregnancy is the first most common risk factor for developing VVV. A significant and sustained increase in progesterone levels in the early stages of pregnancy reduces venous tone and aggravates impaired blood flow. In addition, VBT affecting the perineum and vulva involves compression of the large veins of the retroperitoneal region (the veins of the veins and the inferior vena cava) by the pregnant uterus.
Doctors recommend wearing a compression garment during pregnancy.
Varicose veins in the vulva often occur bilaterally. Signs of the disease:
- marked increase in the veins of the vulva at 18 to 24 weeks of first pregnancy with repeated pregnancies from 12 weeks;
- discomfort in the groin;
- pulling, aching, dull pain in the pelvic region;
- pain during intercourse;
- itching of the vulva;
- swelling of the genitals and perineum.
Signs of pathology progress as the pregnancy progresses. In addition to increasing the size of the varicose veins, its compaction is determined by the third trimester. A characteristic symptom of IV is a combination with inguinal varicose veins or leg varicose veins during pregnancy.
Instrumental examination of varicose veins in pregnant women is limited to ultrasound as well as ultrasound of the legs, as painful lesions of the venous bed undergo involution during the postpartum period.
In most cases (about 80%), the symptoms of varicose veins during pregnancy begin to decrease from the first days of childbirth and are reduced to a minimum 2-8 months after the birth of the baby. The full return of the diameter of the vessels to their original value does not occur.
In 4-8% of women, the IV does not disappear after childbirth and the disease progresses.
An interesting feature is the relationship between the end of the lactation period or the decrease in the amount of breastfeeding and the rate at which the groin varicose veins in women disappear. The shortened lactation period is associated with a decrease and disappearance of dilated veins, and vice versa. This demonstrates that varicose veins during pregnancy are associated with changes in hormone levels.
Treatment of perineum varicose veins during pregnancy
Phlebotropic therapy is the basis for the treatment of varicose veins during pregnancy. In most fertile women, IV begins in the II and III trimesters. Diiodine preparations may be used during this period. The severity of the symptoms of the pathology is reduced by the micronized purified flavonoid fraction. Itching is relieved by zinc paste and H1-histamine receptor blockers.
Low molecular weight heparin in prophylactic doses prevents venous thrombosis and pulmonary embolism (blockage of blood vessels).
As an option for compression treatment, tight, flexible underwear should be worn using latex or gauze pads. Relieves puffiness of the labia and a feeling of heaviness. The special compression field helps a lot for women with varicose veins.
If a complication occurs, such as local thrombophlebitis, surgical treatment is required.
When a conglomerate of varicose veins is found on the genitals, the question arises as to the mode of transport. Natural childbirth is allowed with pubic varicose veins. On the contrary, the risk of surgery during a cesarean section is higher than bleeding from painful blood vessels during childbirth. This is rare. But cesarean sections are often used for cesarean section.
Prevention of varicose veins in the labia
The main factor in the development of groin varicose veins is the wear and tear of the fetus. It is difficult to name preventive methods, given the fact that a number of therapeutic measures are limited during pregnancy. Here are some tips to follow:
- eliminates physical and static stress;
- follow the diet;
- perform therapeutic exercises in which the movements accelerate the outflow of blood from the legs and lower pelvic organs;
- in case of disturbance of the function of the veins, in the presence of varicose veins before pregnancy, phlebotropic drugs should be taken, compression underwear should be worn.
An effective method of prevention is surgery for ovarian veins, surgery for other pathologies associated with varicose veins. This reduces the phenomenon of pelvic venous congestion, reduces the risk of developing varicose veins in the labia.
Pubic 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 for chronic venous patients, it is important to distinguish between the disease and the methods of diagnosis and treatment.