Varicose veins of the small pelvis: treatment and prevention

Varicose veins in women are most often associated with heaviness in the legs, dilated veins in the calves, and discomfort when sitting or walking for long periods. Few people know that varicose veins also occur in the small pelvis, which causes considerable discomfort to the fair sex and greatly limits their quality of life.

In this article we will consider the disease, talk about the treatment and, most importantly, the prevention of this disease.

Some data on the disease

Varicose veins of the small pelvis in women (VVVMT) are a complex medical problem. Many successful cases of the treatment of this chronic disease have been described. At the same time, BPHMT often goes undiagnosed. With this disease, there is a high probability of diagnostic errors, especially at an early stage.

BPHMT is caused by two main reasons:

  1. Obstruction of the veins of the pelvic organs (ovaries, fallopian tubes, uterus), causing an increase in pressure in the underlying areas and their expansion.
  2. Blockade of large venous trunks, in which a vast network of "bypass" (collateral) routes of venous outflow develops with their expansion.

VVMT occurs more and more often with age. Thus, it can be found in 20% of 17-year-old girls. In perimenopausal women (45-50 years), the incidence of VVMT is already 80%.

80% of all cases of VVMT are enlarged veins in the ovaries. Very rarely (1%) varicose veins of the broad ligament of the uterus are observed.

Causes and mechanisms of development of the disease

sedentary work as a cause of pelvic varicose veins

Sedentary work and a sedentary lifestyle increase the likelihood of a woman developing pelvic varicose veins.

The basis of VRVMT is connective tissue dysplasia. This is a violation of the structure and function of connective tissue throughout the body. It is manifested by the weakness of the elements that connect cells in all tissues. One of the consequences of connective tissue dysplasia is the weakness of the vascular walls, especially in vessels with a small amount of muscle tissue, that is, in the veins. The reason for the development of connective tissue dysplasia is considered to be the negative effects of the fetus during pregnancy, environmental pollution.

VVMT occurs under the influence of the following provoking factors:

  • prolonged standing or sitting during professional activities; hard physical work;
  • frequent use of interrupted intercourse as a method of contraception, anorgasmia;
  • frequent pregnancy and childbirth;
  • many gynecological diseases, for example, endometriosis, salpingitis, ovarian disease, bending of the back of the uterus (retroflexio);
  • menstrual irregularities, increased estrogen levels; It is possible that hormone replacement therapy and hormonal contraception play a certain negative role.

Symptoms of the disease

The most common symptom of VVMT is chronic lower abdominal pain. Very often they hurt, pull, "damage" the lumbar and groin area. In half of the patients, the pain intensifies before menstruation. Pain can be caused by prolonged sitting or standing, by intense physical exertion. Sometimes sexual intercourse becomes the cause of the intensification of pain.

Many women notice an increase in secretions from the genital tract for no reason. Painful menstruation is characteristic, premenstrual syndrome is expressed.

One of the manifestations of VVMT is pain in the perineal region. Disturbances in urination may appear.

On examination, you can see varicose veins on the thighs, buttocks, perineum.

Diagnostic methods

The main method for diagnosing VVMT is Doppler ultrasound of the pelvic veins. In this study, the veins are visualized using ultrasound. The dilated and twisted veins of the small pelvis are visible on the screen, the speed of blood flow in them decreases. Signs of venous valve dysfunction are determined.

An informative method for the diagnosis of VVMT is transuterine venography. This is a study of the veins associated with their filling with a contrast agent clearly visible on an x-ray. In this way, a series of images of veins is obtained, showing collaterals, dilated veins, thrombosis sites and the state of the valves. The method is contraindicated in case of iodine intolerance (included in the contrast) and pregnancy.

If VVMT is suspected, laparoscopy is performed: examination of the pelvic cavity using an endoscope through a small puncture in the abdominal wall.

The most informative study is selective ovaricography - an X-ray examination of the ovarian veins using contrast.

For the purpose of differential diagnosis with other diseases of the pelvic organs, computed tomography can be performed.

It is necessary to make a differential diagnosis with diseases such as inflammation of the appendages, endometriosis, prolapse of the uterus, postoperative neuropathies, inflammation of the colon or bladder, sciatica, pathology of the hip joints.

Treatment

taking pills for small pelvic varicose veins

Treatment of this disease includes taking venotonics and drugs that improve blood circulation, in combination with regular physical therapy.

ERCT therapy is aimed at achieving the following objectives:

  1. Cessation of blood flow back through the veins of the ovaries.
  2. Normalization of venous tone, improvement of blood supply to tissues.
  3. Withdrawal of symptoms: pain, bleeding and so on.

Treatment of EMCT includes two main components:

  1. Course of drugs for exacerbation.
  2. The constant use of physiotherapy exercises for the prevention of relapses.

In drug therapy, the main role is played by venotonic drugs (improving the tone of the veins) in combination with angiagregants (preventing the formation of blood clots in the veins).

If repeated courses of venotonic drugs are ineffective, surgical treatment is possible.

The best method is artificial blockage (embolization) of the ovarian veins. It is performed using a special sclerosing substance, which is injected through a thin catheter under radiographic control. This surgery is less traumatic and effective.

If such an intervention is impossible, surgical removal of the affected veins is performed.

Symptomatic treatment is the use of non-steroidal anti-inflammatory drugs for pain.

Folk remedies

The most popular folk remedies for varicose veins are horse chestnut, dandelion root and kombucha (chaga). Pharmaceutical infusions and tinctures of these agents prepared in different ways normalize the venous tone. They can be used to treat varicose veins not only of the lower limbs, but also of the small pelvis.

Prophylaxis

  1. Normalization of working conditions with the exclusion of prolonged sitting or standing. Industrial gymnastics, regular breaks from work. Elimination of heavy physical exertion, heavy lifting.
  2. Normalization of stool, relieving constipation. The diet should contain more vegetable fiber and vegetable oil. Stop drinking alcohol and smoking. Exclusion from the diet of spicy and salty foods.
  3. Daily shower of ascending perineal contrast.
  4. Exercises in the prone position with the legs raised ("bicycle", "birch", "scissors").
  5. Respiratory gymnastics: slow breathing with the participation of the abdominal muscles.
  6. Wear special medical grade II compression tights.
  7. Prophylactic intake of venotonic drugs in courses 3 - 4 times a year.

Effective treatment is recognized in cases where the symptoms of the disease cease, venous outflow improves according to instrumental studies and improves the patient's quality of life.

Which doctor to contact

If the diagnosis has already been established, it is best to be treated by a phlebologist, a specialist in venous diseases. If a woman does not know the cause of constant pain in the lower abdomen, it is recommended to consult a gynecologist. In case of difficulty, a neurologist and a urologist are examined. The qualifications of a radiodiagnostic and ultrasound doctor play an important role in the recognition of the disease. Treatment involves a physical therapist, a physical therapist, a nutritionist, and in some cases a vascular surgeon.