Venous pathologies in women are a common phenomenon. Gender is determined by hormonal changes, lifestyle characteristics, body functionality and other factors. Veins can be damaged under the influence of external and internal factors. This leads to stretching of blood vessels, thinning of the walls, formation of plaques, valve dysfunction, thickening of the blood and other negative consequences. Varicose veins of the small pelvis in women are a type of venous pathology. It is characterized by discomfort, pain, a feeling of heaviness and tightness, and sometimes even leads to dysfunction of the reproductive system.
What are varicose veins of the small pelvis
Phlebeurismis a pathology characterized by a change in the normal state of the vessels and veins of the human body. ICD-10 does not have a separate classification. Vein diseases are designated by the code I80-I89. A separate classification includes varicose veins of the lower extremities (I83. 9), which is often combined with varicose veins of the small pelvis in women.
With varicose veins of the small pelvis, there is a thinning of the walls of blood vessels, their expansion and stretching. In this state, the blood stagnates. Due to the decrease in tone, the vessels are unable to function fully and pump blood, as a result, peculiar nodules form in them, popularly called varicose veins.
In recent years, there has been a trend towards rejuvenation of the disease. If earlier varicose veins of the small pelvis affected mainly older women, now the pathology is increasingly found in young patients. According to statistics, up to 20% of women of childbearing age have varying degrees of varicose veins. Pelvic varicose veins (PVVD) are often accompanied by other pathological processes, which seriously complicates the diagnostic procedure.
Varicose veins affect the function of the pelvic organs. It may be accompanied by severe symptoms or have no clinical manifestations. In difficult situations it becomes the cause of complications. Treatment for varicose veins is selected individually and does not always achieve the desired result.
Classification of varicose veins of the small pelvis
Varicose veins in the pelvis occur differently in different women. Some patients complain of severe symptoms, while others have practically no pathological manifestations. For some, even serious treatment does not allow them to completely get rid of the pathology, while others can easily cope with the disease through lifestyle changes. In gynecology, a classification of varicose veins of the small pelvis has been adopted, which accurately characterizes the development of pathology.
Forms of varicose veins of the small pelvis
Varicose veins of the pelvis in women are accompanied by a decrease in the tone of the vascular wall, weakening, a decrease in elasticity and the formation of ectasia - an increase in the lumen in a limited area of the vein.
There are two forms of pelvic varicose veins:
- Varicose veins of the vagina and external genitalia (perineum)- characterized by a change in the structure of the ducts of the great vein, with which the external genital vein is affected. Often the cause is long-term pregnancy, during which compression of the inferior vena cava and iliac vein occurs by the enlarged uterus.
- Venous congestion syndrome- characterized by the expansion and stretching of the veins within the small pelvis and the return of blood through them. The causes of this reflux can be very diverse.
Stages of varicose veins of the small pelvis
Varicose veins of the pelvic organs can occur in three stages. As the disease progresses, one stage replaces another. The stages of the disease differ in the severity of symptoms and the severity of the disease.
- First step
Characterized by dilation of veins up to 5 mm in diameter. Vascular tone decreases and the mesh takes on a tortuous appearance.
- Second stage
It is characterized by a decrease in the elasticity of the vascular bed of the pelvis. The diameter of the dilated veins is 6 to 10 mm. The parametrial vessels and ovarian plexuses are affected.
- Third stage
Characterized by total damage to the vascular fiber. The expansion diameter exceeds 10 mm. Against the background of progressive varicose veins, a woman may develop complications.
Nature of development
According to the nature of occurrence and development, varicose veins of the small pelvis are classified:
- Primary varicose veins of the pelvic veins in women
It is formed against the background of acquired or congenital valve pathologies. Doctors often talk about valve insufficiency of the veins, which is accompanied by the appearance of tortuous and distended vessels. Often the causes of primary varicose veins are increased physical activity, complications during pregnancy and childbirth, and the use of hormonal medications.
- Secondary varicose veins of the pelvic veins in women
Formed against the background of past illnesses. Infectious pathologies, tumor processes, pelvic endometriosis and abnormal development of the pelvic organs can affect vein tone.
Causes of the development of varicose veins of the small pelvis
Pathologies of the veins of the pelvic organs can develop for the following reasons:
- Heredity. Often, venous diseases in women are hereditary. If a mother, grandmother or aunt in the family had varicose veins, the disease is likely to affect the next female generation.
- Connective tissue dysplasia of the pelvic organs. It is a congenital anomaly and is characterized by a decrease in collagen production, in which the tone of the vascular pattern decreases.
- Pregnancy. During pregnancy, the load on muscles and blood vessels increases greatly. The growing uterus puts pressure on neighboring tissues and adjacent veins. With polyhydramnios, multiple pregnancies, large fetuses and other conditions, a woman can develop varicose veins.
- Excess body weight. With obesity in women, pressure on the pelvic organs increases. This can lead not only to the development of varicose veins but also other health problems.
- Decrease in physical activity. The human body needs regular physical activity. We're not talking about exhausting workouts. On the contrary, excessive physical activity can become an independent cause of varicose veins of the small pelvis. With a sedentary lifestyle, blood flow in the pelvis is disrupted and stagnant processes develop.
- Hormonal disorders. The functioning of the entire female body is completely subject to hormonal levels. Hormonal changes and the use of hormonal medications can cause a decrease in vascular tone.
Varicose veins of the lower extremities are often accompanied by varicose veins of the small pelvis. If a woman has tortuous vessels on her legs, she should definitely undergo an examination of the pelvic vessels and, if necessary, undergo treatment.
Risk factors
The risk of developing pelvic varicose veins in women increases with the following factors:
- bad habits;
- binge eating;
- disruption of the gastrointestinal tract and tendency to constipation;
- lack of intimate life;
- difficult pregnancy;
- surgical interventions;
- pelvic organ injuries;
- hormonal treatment;
- heavy physical activity.
Symptoms of varicose veins of the pelvic organs
Many women do not experience symptoms of pelvic varicose veins. The disease can exist for a long time without clinical manifestations. At the same time, the pathology is insidious because it progresses imperceptibly, resulting in serious health problems.
Signs of varicose veins of the small pelvis in women may be similar to other gynecological pathologies. Therefore, when choosing treatment tactics, it is necessary to carry out differential diagnoses and exclude other diseases of the pelvic organs.
General symptoms of varicose veins of the small pelvis:
- pain in the lower abdomen;
- breakthrough abnormal uterine bleeding;
- discharge that is unrelated to the menstrual cycle;
- sensation of distension and presence of a foreign body in the pelvis;
- lumbago in the sacrum, lower back, leg, perineum;
- bright premenstrual syndrome;
- severe pain during menstrual bleeding;
- discomfort and pain during intimacy;
- frequent urination;
- digestive tract dysfunction.
A characteristic sign of varicose veins in the pelvis in women is the formation of tortuous, bluish veins in the region of the external genitalia and vagina.
Diagnosis of varicose veins in the pelvis
A preliminary diagnosis can be made based on the patient's complaints and clinical examination. Visually, varicose veins look like cyanotic nodules and dilated vessels. Since the signs of pathology are often confused with other gynecological diseases, to clarify the diagnosis it is necessary to carry out diagnostics:
- visual examination of the external genitalia;
- examination of the vagina and cervix using speculums;
- palpation and diagnosis of the functionality of the valves in the inguinal region;
- Ultrasound of the pelvic organs;
- Doppler study;
- Computed tomography;
- magnetic tomography;
- hysteroscopy;
- laparoscopy.
Treatment of varicose veins of the small pelvis
The treatment of pelvic varicose veins in women can be surgical, conservative or complex. The treatment method is selected individually, in accordance with clinical manifestations, the stage of varicose veins, the cause of the development of venous pathology and other factors. The main objective of treatment is to reduce the symptoms of the disease and improve quality of life.
Drug treatment of varicose veins of the small pelvis
For varicose veins of the small pelvis, the doctor selects an individual drug treatment regimen. The following medications are traditionally prescribed:
- Venotonics. Modern pharmacology offers many types of venotonics. The main task of medicines is to increase the elasticity of blood vessels, normalize blood flow and stabilize the work of valves. Medicines can be used both internally and in the form of ointments.
- Anticoagulants. Medicines are prescribed for blood thickening due to pelvic varicose veins. This parameter is determined by laboratory tests. Anticoagulants prevent the formation of blood clots and reduce the thickness of the blood.
- Nonsteroidal anti-inflammatory drugs. Medications are used for severe pain and as an additional remedy for the inflammatory process. As a rule, NSAIDs have a symptomatic effect. They alleviate the signs of varicose veins of the small pelvis, but do not completely solve the problem.
- Vitamin complexes and microelements. Since most people are nutrient deficient and do not get enough from food, supplemental vitamin intake is recommended. For varicose veins, it is recommended to take vitamins B, C, D.
Surgery
If drug treatment is unsuccessful, it is recommended to consider the possibility of surgical treatment of pelvic varicose veins. The operation is also performed for severe forms of varicose veins.
A modern method of treating dilated veins is endovascular embolization of the gonadal vessels. The procedure is performed in a hospital environment under general anesthesia. The operation involves inserting coils that block the duct through a catheter into the dilated vein. As a result, blood flow is completely stopped in the pathological area. It should be noted that the operation is safe in terms of damage to the circulatory system. As the dilated veins themselves are pathological and can no longer function properly, it is advisable to exclude them from general circulation. Refusal of treatment is accompanied by an increased risk of blood clots forming in the vessels.
The endovascular embolization procedure allows the problem of varicose veins of the small pelvis to be resolved in 95% of cases. In the future, it is recommended that women undergo lifelong prevention of vascular diseases.
General recommendations for women with pelvic varicose veins
At any stage of varicose vein treatment, as well as after completing the correction technique, doctors recommend that women wear compression garments. After the operation, the period of wearing such a shirt is determined individually. Typically, for the first few days after surgery, socks are worn 24 hours a day. In the future, it is allowed to remove the compression during sleep.
Women with pelvic varicose veins are not recommended to practice strenuous sports or carry weights. Baths, saunas and hot baths should be completely avoided. Thermal procedures can aggravate the course of varicose veins.
In varicose veins, special attention should be paid to body weight. Excess weight can become a stimulator of varicose veins. Therefore, it is important to stabilize body weight and lead an active lifestyle.
Why are varicose veins in the pelvis dangerous for women?
Complications of varicose veins:
- thromboembolism;
- thrombophlebitis;
- venous thrombosis;
- hemorrhoids;
- hormonal imbalances;
- abnormal uterine bleeding;
- chronic pelvic pain;
- infertility.
Pregnancy and varicose veins of the small pelvis
Varicose veins are generally not a cause of infertility. Enlarged and distended veins can be an increased risk factor for women planning to become pregnant. It is impossible to say right away how the pregnant woman's body will behave. The uterus is the main organ of the fetus. If the blood flow in the reproductive organ is impaired or blood circulation in the placenta is obstructed, there is a high risk of miscarriage or the formation of various intrauterine disorders.
Prevention of varicose veins of the small pelvis
There is no specific prevention for varicose veins of the small pelvis. Every woman is at risk of developing varicose veins. Therefore, everyone needs to follow simple rules:
- healthy lifestyle;
- Good nutrition;
- obesity prevention;
- rejection of bad habits;
- moderate physical activity;
- drink plenty of fluids;
- refusal to wear high heels for a long time;
- a rational approach to pregnancy planning and the prevention of pregnancy complications;
- use of compression belts with a high risk of varicose veins;
- regular scheduled medical checkups.
If varicose veins of the small pelvis have already been detected, the doctor will give recommendations on how to prevent the progression of the disease. As a rule, a woman is prescribed a course of venotonics and regular wearing of compression garments.