Varicose veins – pelvic ectasia of the vessels of the venous system pelvic, causing the disruption of bleeding external and internal genital organs. It manifests as a visible extension of all the veins, accompanied by local swelling, feeling of gravity and pain of the head, bleeding. Characterized by pelvic pain, dysmenorrhea, dyspareunia, and Dr. symptoms. Varicose veins of the pelvis is diagnosed through a pelvic exam and ultrasound, phlebography, computed tomography, laparoscopy. The treatment of the syndrome can be conservative (taking the pills, therapy, exercise) or surgical (embolization special veins, phlebectomy, and Dr.).
Varicose veins pelvic – disease of the veins the pelvic, related to the violation of their architectonics and stasis of venous blood in the pelvis. In the literature varicose veins pelvic also is indicated in terms of "syndrome of venous thrombosis pelvic infinity", "varicocele women", "the syndrome of chronic pelvic pain head". The prevalence of varicose veins of the pelvis increases proportionally with the age: from 19.4% in girls under the age of 17 years up to 80% in women in perimenopause. More often the pathology of the pelvic veins are diagnosed reproductive period of female patients in the age group of 25-45 years. In the great majority of cases (80%) the varicose veins transformation is affecting the ovary of vienna, and it is extremely rare (1%) observed in the veins of the ligament off of the uterus. According to medical approaches to the treatment of varicose veins should be carried out not only with the positions of gynecology, but, above all, with the positions of phlebology.
The causes of varicose veins in the pelvic
The basis of varicose veins of the pelvis is considered to be the dysplasia of the connective tissue, which holds 35% of healthy people. This state is innate and is characterized by a decrease in the content of some types of collagen, contribute to the reduction of the strength of the connective tissue, t. h. component of the vessel wall. The period of manifestation of such pathology can serve nadrazitie or the lack of any component of morphological vascular wall. System loss of connective tissue explains the frequent combination of the varicose veins pelvic with varicose veins of the veins of the lower limbs and hemorrhoids. In addition to getttionarytKanna and dysplasia, a certain "debilitating" effect on the tonus of the venous system of the pelvic floor in women who have sex hormones (mainly progesterone), and thrombosis of the veins the pelvic.
Factors that increases the risk of varicose veins pelvic, are heavy physical activities; work, along with the obligation of long find yourself in the position of standing or sitting; pregnancy and childbirth, trauma to the pelvis, the lack of orgasm in women. One of the gynaecological problems more a significant impact on the development of the varicose veins have endometriosis, tilting the vagina and the uterus, tumors of the uterus and ovarian cancer, varicose veins of the uterus and the Dr. does Not exclude the cushion role of hormonal contraception and hormone replacement therapy.
Rating varicose veins pelvic
Varicose veins of the pelvis can manifest itself in two forms: varicose veins in the vulva and the perineum and the syndrome of thrombosis venous plethora. More than half of the cases, both forms that determine and maintain for each other. Isolated strong and prominastNY varicose veins often occurs as a result of a reflux of blood through a vessel with the defeat outside the sexual of vienna and the influx of a large fabric of vienna. Occurs in 30% of pregnant women, after delivery, except those from 2-10% of women. The main provocative factor in varicose veins of perineum and vulva serves the growing pressure of the uterus on the iliac and lower hollow vienna. A pre-requisite for varicose veins pelvic acts flow of blood to the ovarian vienna.
Stand out 3 intensity of varicose veins pelvic taking into account the diameter and location of the venous disease:
- 1 degree – the blood vessels have a diameter of up to 0.5 cm and iswitOh course; the loss can affect any of the venous is woventProtocol pelvic;
- 2 degree – the blood vessels have a diameter of 0.6-1 cm; in a defeat you can take the total of the character, or affect the plexus of the ovary, or other of vienna, or of the gardentnye vienna myomatRiya;
- 3rd degree – the blood vessels have a diameter of more than 1 cm varicose veins total of the type or the trunk type.
The symptoms of varicose veins in the pelvic
Framework framework clinical different the varicose veins is visible to the naked eye the extent of the vessels of veins in a given area. Subjective complaints may include a feeling of itching, discomfort, and severity of severe headaches in the outer area of the genitals. During the inspection can be identied, swelling of the lips. Perhaps the membership of spontaneous or post-traumatic bleeding, more driven to sexual intercourse or childbirth. Due to the thinning of the venous wall and high pressure in the varicose veins to stop this bleeding paired with certain difficulties. Another complication of varicose veins, this location can become sharp thrombophlebitis of the vein in the groin. In this case, you experience intense pain, flushing and swelling of the skin of the groin. Dead varicose veins of vienna, become dense and painful to the touch. Develops Hypertfermionshesky syndrome – the rise of body temperature up to 37,5-38,0 °With.
Another form of varicose veins - pelvic syndrome venous thrombosis myriad – you can give a polymorphic clinical picture, which is often taken inflammatory gynecologistsheskow pathology, colitis, cystitis, sciatica, and Dr. constant, a sign that the pain in the lower part of the abdomen, with different intensity, the nature and the irradiation. Often the patients describe their sensations, pain, pain, ontдающie in the lumbar region, the groin or in the groin. Almost half of the women with varicose veins of the pelvic floor notes gain from the starting point of the pain syndrome of the second phase of the menstrual cycle. Many times pain is caused sexual long seat or withtonянieм, physical exercise. For the syndrome of thrombosis venous plethora pelvic typically the presence of expressed pre-menstrual syndrome, dyspareunia, desurihеwithких disorders.
Diagnosis varicose veins pelvic
The diagnosis of varicose veins of the pelvis develops from a standard pelvic exam, ultra-sound scanning UNWTO and of the veins of the lower limbs, pelvic phlebography, CT scan of the pelvis, laparoscopy. In the examination of patients with suspicion of varicose veins should participate gynecologist and Dr.
During the inspection of the outside of the genitals are detected, the advanced surface of vienna, in the area of the vulva and perineum; to the touch the vaginal determined cyanosis of the vaginal walls, pain during palpation of the abdomen. Confirm varicose veins allows ultrasound pelvic organs, with the more useful is the combination of ultra-sound+TV access. The research not only provides the opportunity to identify the pathology, but also with the mode of ultra-sound to detect clusters of varicose veins with alteration of bleeding pathological reflux of blood. According to the ultrasound of the vessels determined the reduction of the peak velocity of the blood flow in the fallopian tubes and internal iliac vein. In the framework of the evaluation of venous thrombosis state of the patient advisable to carry out an ultrasonic diagnosis of the veins of the lower limbs.
With the aim of studying the location and prevalence of varicose veins of the pelvis, the state of the valve system and anastomoses venous, as well as the detection of blood clots is especially made venography. The syndrome of thrombosis venous plethora can be shown to be a selective procedure, suggesting the introduction of contrast directly into the ovary of vienna. When isolated varicose veins is used кonнtраwithtирonванie vein in the groin. Currently, the change in the x-ray comes CT the pelvic organs, not less, to them diagnostic significance. Part of the differential diagnosis, as well as lack of relevance, the following methods, resort to diagnostic laparoscopy.
The treatment of the varicose veins pelvic
During pregnancy is possible only symptomatic therapy of varicose veins pelvic. Recommended wearing compression кonлгont, the intake of medicines by the recommendation of the vascular surgeon. II-III quarter, may be accomplished in the treatment of varicose veins vein in the groin. In communication with varicose veins there is a high risk of bleeding during independent childbirth, the choice is made in favor of operations delivery.
Conservative tactic can be effective when varicose veins 1-2 degree. Foreign exchange and the receipt of special medications, NSAIDS, lessons of healing, physical exercises, ascending, sensation showers, the normalization of work conditions and physical activity, the selection of compression of knitted fabrics and other measures can slow the progression of varicose veins and significantly improve the well-being. When there is dysfunctional uterine bleeding is attributed with the particular therapy. In some cases, пацieнtke may need help from a therapist.
Strong pain that is caused, and also varicose veins pelvic 3 degree serve as indication for the surgical treatment of the pathology. The modern techniques of minimally invasive surgery refers to embolization of the portal vein ovarian, that are performed under special control. During the intervention under local anesthesia in the lumen of the vessel is introduced to the substance, or installed a special spiral, resulting achieved obliteration/occlusion of the vein gonadal. A possible alternative can serve the resection of the vein with special access or endoscopic stapling. If the cause is varicose veins, serves as a disease of the uterus, is made of plastic of your withвязonhнonгon device.
When isolated varicose veins can be performed phlebectomy in the groin. The operation, which is often supplemented with resection of the small or large lips. In the case of the combination of the varicose vein of the groin and of the lower limbs, shows a special type of procedure.
Prevention varicose veins pelvic
Preventive measures designed to reduce the risk of onset and progression of varicose veins pelvic, boil down, mainly, to the normalization of life style. In this queue, the main role belongs to the elimination of long, static, and heavy physical exercise, correction of the diet (the inclusion of a large number of fruits and vegetables), denial of the use of alcohol and smoking. When the initial symptoms varicose veins recommended medical and breathing, gymnastics, wearing mesh compression, the holding of courses of prevention conservative therapy. In this case, it is possible to achieve a long remission and improvement of the quality of life of patients.