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Varicose veins of the pelvis: symptoms, treatment

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Varicose veins of the pelvis Varicose veins of the pelvis mainly affect women of childbearing age. This pathology is often confused with uterine varicosity, although it is different in origin and in its manifestations of the disease.

Such a disease usually develops during pregnancy, but there are cases of its occurrence and asymptomatic occurrence even in adolescence.

Varicose veins of the pelvis, extending to the perineum and vulva, during pregnancy is observed in 30% of women. The main reason for this phenomenon is the decrease in the elastic properties of the venous walls, occurring against the background of increasing hormonal levels. In the conditions of compression of large veins of the retroperitoneal space, the formation of collateral outflow tracts takes place, including through the system of gonadal veins. Enlarged veins of the vulva and perineum after childbirth are usually subjected to reverse involution.

Outside of pregnancy, varicose veins of such localization are observed only in 2-10% of cases. The most important step in the formation of pain in this case is the reduction in blood flow velocity in the microcirculation system.



The reasons

As mentioned above, the most common cause of the disease is pregnancy, or rather, the return flow of blood (reflux) through the ovarian vein, which, in turn, is caused by compression of pelvic vessels or changes in hormonal levels during pregnancy.

In addition, the causes of pathology can be:

  • sedentary sedentary work;
  • numerous genera;
  • congenital pathologies of connective tissue;
  • excessive exercise;
  • inflammatory gynecological diseases;
  • increased estrogen production;
  • sexual dysfunction.

Among the adverse factors include such features of sexuality as frequent interruption of sexual intercourse, the absence of orgasm. In recent years, experts say about the harmful effects of hormone replacement therapy and contraception. This is supported by the fact that in the post-menopausal period the manifestations of the syndrome are significantly reduced.

Classification

In the development of this pathological process, there are 3 stages:

  • the first stage, for which the characteristic diameter of the veins is within 5-7 mm with the localization of the process along the upper edge of the left ovary;
  • the second stage, with a diameter of veins of 8-9 mm, the pathological process extends to the entire left ovary, the veins of the right ovary and uterus are also enlarged;
  • the third stage, in which there is observed a diameter of the veins from 10 to 13 mm, and on the left and right ovaries they are almost identical, the veins of the left ovary in this case are located below the lower edge.



Symptoms of varicose veins of the pelvis

There are two options for the occurrence of this disease - venous plethora of the pelvic organs and varicose veins of the perineum. The symptoms of these conditions are approximately the same as the causes of them. Most patients have the following complaints:

  • pain in the lower abdomen;
  • heavy discharge from the vagina;
  • pronounced premenstrual syndrome;
  • menstrual disorders;
  • urination disorders.

These symptoms in different patients may manifest themselves in various combinations. Some of the patients note almost all of them, and some of them only have one or two. The most characteristic sign of the disease is the presence of exhausting pain in the lower abdomen, not explained by any visible changes. Another predominant symptom in the majority of patients is copious mucous discharge.

The symptoms of this pathology of the veins are most pronounced after exercise, as well as at the end of the menstrual cycle. The existing varicose veins of the legs may suggest the presence of this particular disease. After all, the same factors become the causes of the development of both diseases.

On examination, a change in the superficial veins in the area of ​​the buttocks, in the perineal area and on the posterior outer surface of the thigh is usually detected.

Diagnostics

Symptoms of the disease in many ways resemble the manifestations of other gynecological diseases - fibroids and uterus prolapse, endometriosis. Therefore, when making a diagnosis, it is necessary to exclude them, what is the difficulty of diagnosing this disease. Also, to confirm varicose veins, it is necessary to detect the localization of reflux, i.e. the place from which the blood is returned to the perineal veins.

For this reason, the examination required for diagnosis includes:

  • vaginal examination;
  • Ultrasound;
  • vascular Doppler;
  • trans-abdominal phlebography;
  • laparoscopy;
  • computed tomography.

Ultrasound examination should be performed using not only abdominal, but also transvaginal sensors. Varicose veins are found in the form of multiple conglomerates and lacunae, whose blood flow is weak and multidirectional.

Doppler study of blood vessels helps to identify the existing nuances of blood circulation in the vascular formations of this area. Using phlebography, the functional capacity of the veins is evaluated and the existing features of the local blood flow are identified.

Computed tomography is prescribed only in cases that require a refined diagnosis. First of all, it is necessary to exclude other diseases localized in this area.

Such a large number of diagnostic procedures makes the diagnosis reliable and eliminates the possibility of erroneous treatment. For example, in adolescence, pelvic varicose veins are often mistaken for banal colpitis and instead of treating a venous disease, the vaginal mucosa is treated. Therefore, if a patient is addressing with pains of unclear etiology, then one should, first of all, find out which factors contribute to their strengthening and conduct a comprehensive examination with all the care.

Treatment of varicose veins of the pelvis

Even the highest-quality treatment does not allow to completely cure varicose veins of the pelvis. But, nevertheless, adequate therapy allows you to get rid of most of the clinical manifestations and significantly improve the patient's condition. It helps to solve the following tasks:

  • normalization of venous tone;
  • prevention of stagnant processes in the pelvic vessels;
  • improved tissue nutrition.

Experts advise drug therapy combined with physical therapy and wearing compression underwear. The complex of recommended physical exercises includes “Birch”, “Bicycle”, “Scissors”. It is also possible to improve the outflow of blood from the venous plexuses with the help of breathing exercises, which consist in alternating slow deep breaths and exhalations. A rising douche is recommended for the crotch area. Wearing class II compression tights for such patients is mandatory.

Because of the internal location of the diseased veins, medicines are prescribed orally, it is not possible to use venous gels and ointments. The following means are used:

  • venotonic;
  • improving blood rheology;
  • nonsteroidal anti-inflammatory;
  • hormonal;
  • vitamins.

Removal of venous plethora reduces the degree of varicose veins of the pelvic organs. For this purpose, course prescriptions are prescribed for phleboprotectors such as Detralex, Venoruton, Ginkor-for. When expressed pain nonsteroidal anti-inflammatory drugs are used. This kind of therapy is usually prescribed for exacerbations of the disease. As a result, the dilatation of the veins and pelvic plexus decreases, venous blood flow increases, and drainage improves.

With varicose veins of the ovaries, surgical treatment is justified, it is also recommended at the 3rd stage of the disease. The purpose of the intervention is to overcome the pathological reflux. The optimal method is, produced under the control of angiography, embolization of the ovarian veins. In order to increase the effectiveness of the intervention, the additional administration of a phlebosclerosing drug in a state of fine foam is carried out. This method is called embolization by the "sandwich" method.

Recently, minimally invasive methods of surgical treatment of this pathology have been introduced into practice.

Traditional methods of treatment

In addition to traditional medicine for diseases of this kind can be used folk remedies. The most effective ones are the following:

  • tincture of horse chestnut;
  • tea fungus infusion;
  • tincture of dandelion roots;
  • hirudotherapy

When treating with leeches, they are placed on the region of the sacrum or the coccyx.

An important role is played by a balanced diet, which should contain a sufficient amount of plant fiber and animal proteins. Helps maintain vascular tone and tissue metabolism in carrots. Therefore, it is recommended to introduce it into the diet in the form of salads and juices.

Complications

The most frequent complications of this disease are:

  • diseases of the uterus and inflammatory appendages;
  • bladder disease;
  • uterine bleeding.

In conditions of impaired venous outflow there is a risk of pelvic venous thrombosis. But the frequency of this type of complications does not exceed 3-5%.

Features of the disease in men

Although the majority of patients are women, men are also susceptible to this disease. The essence of the disease in the male version is a violation of the valves, which are located in the veins of the spermatic cord. Normally, this valve apparatus prevents the reverse flow of blood through the veins. When an enlargement of the veins occurs, the valves become untenable, and the blood performs pendulum movements. The result is a slowdown in blood flow, equalization of body temperature and testicles, and, as a result, inhibition of testicular function. The hardest consequence of this is complete male infertility.

The reasons that cause the appearance of this pathology include:

  • the presence of inguinal hernias;
  • the presence of tumors in the genital area;
  • frequent constipation;
  • nephroptosis of the left kidney;
  • dysfunction of the connective tissue.

As a result of these pathologies, hydrostatic pressure rises, and the reverse flow of blood enters the venous network of the testicle.

The household factors contributing to the occurrence of this problem are:

  • hard physical labor;
  • lack of full sexual life;
  • frequent lack of sleep in combination with high motor activity.

A separate cause of this disease is the non-standard structure of the testes, in which their congenital expansion is noted.

During the course of the disease, 4 stages are distinguished. Notable signs begin to appear already on the second of them. They consist in a slight expansion of the veins on the penis. The symptoms that arise later are as follows:

  • pain in the penis at the time of excitement;
  • change in the size and shape of the scrotum;
  • pulling pains in lower abdomen.

At the last stage, the pain becomes permanent and incessant, the scrotum increases several times, urination becomes difficult. The most dangerous consequence of all this is infertility.

For treatment with a weakly expressed process, venotonic and anti-inflammatory drugs are offered. With a pronounced varicocele , surgical treatment is recommended, the purpose of which is to intersect and bandage all the dilated veins through which reverse blood flow occurs.

There are several types of surgical interventions from different access points. Laparoscopic operations are possible in which the testicular vein is ligated through an incision in the iliac and inguinal regions.

After a successful operation, the number of spermatozoa in the seminal fluid increases, and their quality is improved.

The best way to prevent this disease in men is to avoid excessively heavy loads and problems with the chair, which lead to an increase in intra-abdominal pressure.


| 17 May 2015 | | 3,231 | Surgery
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  • | Oksana | 27 August 2015

    I have a noticeable improvement in the results of the survey after receiving Phlebodia 600. I didn’t even think that the pills would be able to achieve such results and remove the operation for an indefinite period.

Leave your feedback


Jiadi Zhang: Just for those who worry about lowered testosterone level. If you have only a mild varicocele, it wont affect your testosterone level. I have been worried about it like hell so I went to look for the newest researches. Here is the research https://www.tandfonline.com/doi/abs/10.1080/13685538.2018.1550745 Also, dont rush into surgery. The med field still hasnt established a clear relationship between fertility and the surgery. Some scholars suggest varicocele is actually a protective mechanism against damaged testis, and in fact the evidence that surgery can improve fertility is still very questionable.

Had It All: I have varicose vein‘s on my left testicle and it hurts like hell once a while I have to take an anabiotic and lay off the gym for three months about that lots of fun

Connie Gibbs: My deepest gratitude for your excellent presentation. You're concise, peaceable, detailed, and so easy to listen to. This information is invaluable, especially because of how I've suffered with varicose veins and repeated pelvis problems. Thank you again and again. All the best in your practice. I live on the East coast so having you as a doctor isn't possible, but I'm grateful so many others can benefit, in person, from your wisdom and care.

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Ashish Kumar: I am nervous because I masterbate after just 11 days of my microsurgical varicocelectomy now I am nervous that it may cause of reoccurrence of varicocele or other damage tell me what problems I can face really it may cause of reoccurrence of varicocele

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