Varicose veins in the small pelvis in women (ectasia, parametria, dilation or phlebostasis) are triggered by this condition due to the reverse flow of blood through the ovarian artery, which occurs due to vascular compression.
The intensification of the development of the disease is pregnancy.
Internal varicose veins in the small pelvis are expressed by intense and prolonged pain in the abdomen.
In the literature, varicose veins in the small pelvis are also referred to by the terms "pelvic venous congestion syndrome", "varicocele in women", "chronic pelvic pain syndrome".
In the vast majority of cases (80%), varicose transformation affects the ovarian veins and is extremely rare (1%) observed in the veins of the uterine's broad ligaments.
According to modern medical approaches, the treatment of VVMT should be performed not so much from a gynecological point of view, but first and foremost from a phlebological point of view.
The causes of the appearance of pathology
Most often, ectasia is determined by the pelvic veins in women. In addition, this disease is usually diagnosed in gynecology in patients aged 20-40 years.
Often, patients with varicose veins in the small pelvis first try to perform treatment at home. Folk remedies used without the advice and recommendations of a doctor can lead to the appearance of negative side effects, so after a while you should go to a phlebologist for a consultation.
The main factors that lead to the appearance of this pathology include:
- Excessive increased physical activity.
- Passive lifestyle.
- Congenital diseases of the walls of blood vessels - weakness, plasticity, underdevelopment.
- Inflammatory processes in the pelvic organs.
- Hormonal imbalance.
Pathology of the sexual plane - anorgasmia, pain and the appearance of discomfort during intercourse, which have a psychological etiology of the appearance, while very often practicing interrupted sexual contact.
At the same time, varicose veins in the small pelvis, treatment and symptoms of this disease are similar to varicose veins on the legs. In this situation, the valves in the veins begin to interfere with the work of the valves that help the blood circulation to the heart muscle.
Dysfunction of the valves is shown, which acts as a protection for reverse blood flow.
If their work is disrupted, blood stagnation begins in the veins. Veins filled with blood increase in volume, further increasing the phenomenon of stagnation.
Pelvic venous congestion usually occurs near the vulva, fallopian tubes, uterine region and may even dilate the veins in the vagina.
First signs and symptoms
A number of basic clinical symptoms indicate the development of varicose veins. The most important of the signs of this disease are unreasonable pain in the lower abdomen, in the pelvic region, often they begin to radiate to the perineum or to the lumbar region. The patient is also irritated by the abundant discharge of mucus from the vagina, especially in the middle of the monthly cycle.
In addition to the main symptoms, there are also other very important symptoms of varicose veins:
- In some cases, infertility is noted in women.
- Dysmenorrhea. Manifestation of pain during menstruation.
- Noticeable passage of premenstrual symptoms.
- Irradiation of pain in the groin, lower back and sacrum.
- A symptom of dyspareunia (the manifestation of a feeling of discomfort in the vagina or vulva, both during intercourse and after its termination).
- Manifestation of a painful crisis (as a result of a severe hypothermia of the body, excessive physical fatigue, psychoemotional stress).
- The appearance of abdominal pain after prolonged congestion (dynamic or static).
Faced with this clinical symptomatology, it is necessary to consult a doctor as soon as possible, as this pathology can have a large number of unpleasant complications:
- varicose veins can be a contraindication to natural delivery;
- the work of reproductive organs is disturbed;
- there is fear of sexual contact;
- irritability and anxiety occur.
It should also be said that all of the above symptoms can manifest in different ways, in some patients all signs of the disease are noted, and in some only a few of them.
Methods of diagnosing the disease
In order to make the correct diagnosis, the patient must undergo a comprehensive examination. If a woman complains of pain that appears for an unknown reason, the specialist first determines all the causes that are factors in the manifestation of the pain symptom. The patient's lower extremities are carefully examined. So you can identify the manifestation of varicose veins. In some situations, a diagnosis is made by a vascular doctor.
The main diagnostic methods are as follows:
- Ultrasound of the venous system. The examination makes it possible to examine the tortuosity and varicose veins.
- Laparoscopy. Determine varicose veins in the ovaries.
- CT. It makes it possible to rule out the disease, to identify varicose veins in the ovaries and uterus, to see the enlargement on the monitor, as well as their twisted nature.
- Selective ovarianography. The most accurate study. It is performed by injecting a contrast agent into the veins of the subclavian and femur.
- Doppler ultrasound. Determines in the veins of the ovaries and uterus a decrease in the systolic rate of the process.
The use of these methods makes it possible to more clearly define the symptoms of the disease.
Degrees and differentiated approach
To standardize the diagnosis and the possibility of an approach to differential treatment, A. E. Volkov divided varicose veins taking into account the site of formation of venous ectasia and the size of the dilated vessels.
Three stages of this disease are classified:
- the first stage - "corkscrew" movement of the vessel, the size of the vein is not more than 6 mm;
- the second stage - the size of the vein is not more than 7-11 mm below the total type of varicose veins, VR of the curved uterine plexus veins, VR of the parametric veins, loose ectasia of the ovarian plexus;
- the third stage - the size of the vein is more than 11 mm below the main shape of parametric formation or total type VR.
Taking into account the severity of the pathology process, you can use medication methods for treatment or surgery.
Methods of treating varicose veins
During stage 1-2 varicose disease, conservative therapy methods are most often used (remedial gymnastics, NPS drugs, venotonics).
Conservative therapy during the syndrome of venous overload is symptomatic, which includes normalization of rest and physical activity, which excludes excessive active loads and prolonged standing.
Once the patient is diagnosed with varicose veins, the treatment procedures are primarily aimed at achieving the following tasks:
- Relief of symptoms of bleeding, pain, etc.
- Restoration of venous tone, increased blood circulation in tissues.
- Cessation of reverse blood flow through the venous system of the ovaries.
It is necessary to realize that even a therapy of very high quality for this pathology will not completely cure varicose veins.
Adequate treatment will, however, make it possible to prevent the most important clinical symptoms and significantly improve the patient's condition.
Treatment of EMCT includes several main components:
- Regular exercises in medical gymnastics to prevent the onset of the disease.
- Course use of drugs during an exacerbation.
Conservative therapy of affected veins
Due to the internal location of the veins infected with pathology, drugs are used orally, it is simply impossible to apply venous ointments and gels.
During this disease the following drugs are used:
- Horse chestnut extract - to relieve inflammation and swelling.
- On the basis of diosmin - to get rid of high vascular elasticity, prevent damage, reduce permeability.
- Vitamin C - strengthens the vessel walls.
Doctors advise to combine conservative treatment with exercise therapy as well as the use of compression underwear. Compression clothing is especially required during pregnancy.
Surgical procedure
Surgical intervention is an extreme method of treatment that is used if the disease is in a very advanced stage and there is an assumption about VR of the veins.
The surgical operation is chosen taking into account the location of the main disorder of the veins and involves the following procedures:
- operation crossectomy - also used for diseases of the veins of the legs;
- ligation of a vein in the genitals (usually performed simultaneously with perineal miniflebectomy);
- ligation of the ovarian vein.
If surgery is necessary, the choice of appropriate manipulations is quite individual, as everything will depend on the location of varicose veins.
Exercise and remedial gymnastics
If we consider the necessary physical exercises, then women during this disease should do at least one of the exercises every day - "birch", "bicycle", "scissors".
A contrast shower in the pelvic area and breathing exercises are also very helpful. At the same time, properly and efficiently performed gymnastics is the fastest way to restore a healthy and normal life.
The simplest but effective exercises are as follows:
- While lying on your back, lift your legs, bend and lift as high as possible. The exercise is done about 10 times.
- Lying position, stretch the legs, then bend, pull to the chest area. Run at least 10 times.
- For half an hour you have to walk around the room. First - on the toes, then - on the heels, after - raising the knees as high as possible.
- Lying on your stomach, take turns lifting your legs up. In the maximum position, the leg should be fixed for a few seconds. At least 7 approaches for each leg.
Folk recipes and means
Varicose veins can be treated at home.
The most famous and common folk remedies:
- Horse chestnut infusion.
- Kombucha tincture.
- Dandelion root tincture.
- Treatment with leeches, which are applied to the coccyx and the sacral area.
Diet plays an important role in the treatment of varicose veins. The daily diet must be balanced and have enough fiber and natural proteins.
Preventive actions
It is also necessary to use a few simple tips that serve as prevention of VVMT. Moreover, if they are constantly observed, they can also improve the general condition of the body:
- Exercise every day.
- Wear special tights for the treatment.
- Add more vegetables to your daily diet. Avoid foods that cause constipation.
- During sedentary work, take breaks, you should walk for at least 10 minutes every two hours.
- Do not abuse alcohol or smoke.
- Do not take hormonal drugs uncontrolled.
- After VVMT surgery, you should take prophylactic doses of medication prescribed by your doctor.
Possible prognosis
If the varicose condition is not treated at all, the veins start to increase even more after a while (by 90%), this threatens with serious side effects, including thrombosis. In the remaining 10% of patients with varicose veins, in whom it occurred after pregnancy, the disease does not develop to a more severe stage, but it never goes away on its own.
If you start the treatment of pathology, you can achieve a full recovery (15-25%, taking into account the severity) or significant improvement (55-60%), especially in the case of the simultaneous combination of the operative and conservative methods. But one way or another, after complex therapy, lifelong prophylaxis must be performed, which consists in adhering to a proper lifestyle, regular medication, or compression support of the veins.