In this article you will learn: why are varicose veins of the pelvis, is considered a separate disease and a form of varicose veins on the legs, one the disease may happen and why. Manifestations and diagnosis of this pathology, as it is properly treated, the chances for recovery.
Varicose veins of the pelvis – the weakening of the walls of inner or outer veins of the pelvic area, leading to excessive extension of their diameter. Varicose changed veins cannot guarantee 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.
The 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, are cosmetic defects in the form of a tortuous dilated vein nodes at the perineum, labia or entrance to the vagina.
The disease can be cured completely, but for the prevention of relapse prevention, necessary for life. To deal with this problem together vascular surgeons, obstetrician-gynecologists.
Varicose veins of small pelvis in men than in women, that does not happen. However this disease there is – varicocele. Mechanisms and manifestations are similar to those in pelvic varicose veins. Dilatation occurs in the left testicle and spermatic cord due to the fact that he left Vienna the egg stagnates the blood. She throws the back of the left renal vein, which flows into the Vienna.
The essence of the disease, how serious it is
The external and internal female sexual organs are well krovosnabjaemah. To ensure a sufficient blood flow in need of a powerful network of venous vessels. Therefore, the venous system of the pelvis in women is well developed. Each mode has a solid wall, fitted with valves, associated with the, which takes place in the vicinity of the veins. All forms of coherent venous network of the pelvic region which collects blood from the perineum, external reproductive organs (vulva, vagina), special structures (ovaries, uterus), and transportorul at the bottom of the Polow vein.
Varicose changed veins of the pelvis differ from the healthy, which are:
- Expanded in diameter;
- They are filled with blood;
- Too complicated;
- Have protrusions in the form of nodes;
- Flabby and weak.
The pelvic veins the impact of varicose veins, you can collect the blood from the external genitalia and other organs, but not capable for the transport of major vessels (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 functionality.
But most of all the varicose veins of the pelvis danger:
- Various disorders of the ovaries;
- Bleeding from the uterus disorders and miscellaneous;
- Infertility, threatened miscarriage and inability to have a natural birth;
- The formation of blood clots in the lumen of the varicose changed veins, which threatens their separation from the place of education and migration in the heart and the pulmonary veins. This is the most dangerous complication which can be 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 implementation directly in the hollow (to the right) or the kidney (left) of Vienna. If a failure occurs, it completely blocks the venous outflow.
- Uniform weakening or destruction of the venous walls all the pelvic veins, – they are all at the same time expand and not contract to propel the blood in the headline sections.
- Reverse reflux of blood from deep vein of the thigh in the superficial sexual vein, which collect blood from the perineum and external sexual organs, prevents the outflow. As a result, the pressure in it increases, and its trunk and all tributaries of the varicose expanded.
The immediate causes for the start of these mechanisms may include the following:
- Congenital weakness or dysplasia (underdevelopment) of the venous walls 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 labour.
- Prolonged lying down or sitting.
- Overweight.
- Pregnancy and the birth of the child.
- Regular interruption of sexual relations for several years, especially in the absence of orgasm.
- Bend uterus posteriorly or anteriorly.
- Pelvic tumors.
- Prolapse of the uterus.
Range of varicose veins classification
On anatomical grounds (the prevalence of) varicose veins of the pelvis are divided into three types:
- Venous congestion in the pelvis;
- Perineal varicose veins, etc;
- The combined forms.
To reflect pathological changes in the disease is divided into three levels:
- First dilated veins of any organ plexus of the pelvis does not exceed a diameter of 0.5 cm, an excessively complex.
- The second is the diameter of the vessels is increased by 1 cm, is a process that is extended not only to plexus organs(uterus, ovaries), but some of them (okolomatocnah cellulose).
- The third enlargement (ectasia) of more than 1 cm, which affect all the veins of blood, near the body, and the trunk of ovarian vein).
Higher than the degree of the disease, the worse the enlarged veins and heavier congestion in the pelvis.
Typical symptoms
Women with varicose veins of the pelvis note:
- Permanent or recurring pain in the abdomen, worse in the evening or after exertion predominantly in the second half of the cycle (close to monthly). The 3 degrees of pain can be very strong.
- Itching, burning, swelling and lividity of the genital organs.
- Painful periods and sex.
- Heavy menstruation and bleeding from the uterus, 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, which 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 way.
- Endovascular venography the introduction of specific drugs in the ovarian vein.
- Computed tomography with contrast.
- A diagnostic laparoscopy.
Treatment
Varicose veins of the pelvis together for the treatment of cardiovascular surgeons or obstetrician-gynecologists. According to modern concepts, the treatment consists of the following areas:
- The normalization of life;
- Conservative treatment;
- Compression and other therapies;
- Surgical treatment.
For the treatment of varicose veins of the pelvis. Experts to make an individual plan of treatment, and the sick women needs to stick for life recommendations for treatment and prevention.
1. The normalization of life
Because the wrong way of life, is a prerequisite and the direct cause of varicose pelvic veins, their 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 not to strenuous physical activity.
- During the day do the handling exercises for the pelvis (exercise birch, bike) or just lying for 10-15 minutes with elevated above the level of the body with the pelvis.
- Reducing weight (obesity).
- Do not take a hot bath, replace it with a cold shower.
- Refrain from alcohol and Smoking.
2. Treatment with medications
Treatment of varicose veins pelvic any degree, is not possible without medical support. At the first stage it is very important medical event, while the second and the third completes the comprehensive treatment.
Use of these drugs:
- Special medicines that strengthen the blood vessels.
- Anticoagulants – thin blood to ease its progress through the veins.
- Drugs that improve the microcirculation.
Additional groups of drugs prescribed according to existing derogations in the body:
- Preparations of female sexual hormones (hormonal disorders).
- Painkillers and anti-inflammatories.
- Drugs to stop blood styptic drugs for the treatment of bleeding from the uterus.
3. Compression treatment
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 on the legs. Compression (compression) of the surface veins from the outside contributes to their evacuation from the blood. If you want to create this effect, you can special socks or shorts with compression therapy socks. They can be purchased in specialized pharmacies, shops, salons, medical products, particularly to choose the right size and strength of compression.
Sclerotherapy – puncture for varicose veins with the introduction of the special clearance of drugs that cause sticking. This treatment is performed on the outer (subcutaneous) of the 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 with surgery if:
- 2-3 degrees of the disease;
- The rapid progression of the disease;
- Planning pregnancy;
- Expressed pain syndrome;
- Regular bleeding from the uterus, and other gynecological disorders.
The main operations in the pelvic varicose veins:
- Laparoscopic – specific operations through the holes in the abdomen. Perform the ligation, the intersection or the removal of the ovarian vein. This eliminates the 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 to the external pudendal vein to the point where the femoral vessels.
- Gynecological surgery – removal of tumors, removal of the bows 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, which has occurred after birth, the pathology is not complemented, 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 a conservative. But in any case, after a comprehensive treatment should be lifelong prophylaxis, consisting of adherence to recommendations on lifestyle, medication or periodic compression to support weakened veins.