Varicose veins (varicose veins) is a disease that is accompanied by an increase in length, the formation of zigzag pathological zigzags of the veins, irreversible enlargement of the lumen and valve failure. The organs of the lower pelvis are involved in the process of varicose veins. The mechanisms of development of the disease are different. The physician included the perineum, external and internal genitalia as atypical foci.
General information about the disease
The process of blood flowing through the veins takes place in such a way that under physiological conditions a precondition is set for the development of stagnation and outflow of blood.
Varicose veins of the vulva (VV) - vasodilation of the external genitalia. The disease manifests itself in women with varicose veins of the pelvis and legs, as well as in pregnant women. In 30% of cases, pelvic varices involve the perineum and vulva.
The initiation of treatment for the disease was delayed due to the location in an intimate place. Women are shy. In some cases, the patient feels no pain or discomfort. But varicose veins of the lips during pregnancy and not only during pregnancy lead to complications: venous thromboembolism (thromboembolism), sexual dysfunction, pain in the perineum, mental problemsand family conflict.
The mechanisms of the occurrence of obstruction of the blood vessels of the pelvis are not fully revealed. The cause of the main form of the disease is called a malfunction of the valves of the gonadal (ovarian) veins. This causes backflow of blood and increases pressure in the venous nodes of the lower pelvis. Valve inefficiencies can be acquired or congenital. It gets worse with age or with pregnancy.
Secondary VVV of the pelvic organs is associated with gynecological diseases: endometriosis, tumors of the pelvic organs.
Diagnosis of the disease is difficult due to the fact that there are no specific symptoms of the disease. It is based on the results of an ultrasound (ultrasound).
To distinguish between the main and minor forms of pathology, the Valsalva test is used during the ultrasound examination. For secondary causes of pelvic varicose veins, negative.
Varicose veins of the labia with VBT
To confirm the diagnosis of varicose veins of the labia, an examination by a physician is required. Symptoms of the disease are as follows:
- varicose veins on the genitals;
- pain in the external genital area;
- feeling of heaviness and burning in the perineum;
- perineal swelling at the end of the day.
Chronic pelvic pain is less common (in 30% of cases).
After the diagnosis is established, a study is carried out to determine the complexity of the pathological process and to appoint appropriate treatment. Several events are being held:
- examination of the perineal and leg veins by ultrasound angioscanning - USAS;
- conduct ultrasound of the pelvic vessels, including the vagina, uterus, parametria, ovaries, ileum, inferior vena cava and renal veins;
- as indicated, multi-tube computed tomography (MSCT), selective ovarian angiography, and pelvic angiography (SOFT) were performed.
Doctors refer to a characteristic feature of labia majora with VBT as a steadily progressive disease associated with changes in the veins in the pelvis.
Treatment of varicose veins of the vulva accompanied by varicose veins of the lower pelvis.
IV treatment is prescribed based on symptoms and diagnostic findings.
In complex drug therapy for the treatment of chronic systemic venous pathology, non-steroidal anti-inflammatory drugs and antivenous drugs are prescribed.
Prescribe pharmacotherapy with antiplatelet drugs, intra-pelvic blockade with anticancer drugs, physiotherapy with ultrasound, therapeutic exercises. Antioxidants and enterobiotics are added to the therapy.
According to the indications, phlebosclerosing treatment is performed - sclerotherapy. The ship was "sealed" with drugs and lasers. It stopped working. The procedure does not use special anesthetic methods. It is performed on an outpatient basis and creates aesthetic effects.
When there are many pelvic veins, enlarged, and backflowing blood through the gonadal (ovarian) veins, surgical removal of the veins is indicated. In the case of labia minora hypertrophy, it is removed.
Vaginal varicose veins during pregnancy
Pregnancy is the first common risk factor for the onset of VVV. A marked and sustained increase in progesterone levels during early pregnancy reduces venous tone and exacerbates impaired blood flow. In addition, VBT, involving the perineum and vulva, is associated with compression of the large retroperitoneal veins (iliac veins and inferior vena cava) by the pregnant uterus.
Doctors recommend wearing compression clothing during pregnancy.
Usually, varicose veins of the vulva are bilateral. Signs of the disease:
- a pronounced increase in the veins of the vulva at the period 18-24 weeks of the first pregnancy, from the 12th week with a repeat pregnancy;
- discomfort in the groin;
- pulling, aching, dull pain in the pelvic area;
- pain during intercourse;
- vulvar itching;
- swelling of the genitals and perineum.
Signs of the disease progress with the course of pregnancy. In addition to an increase in the size of varicose veins, its compaction is determined by the third trimester. A characteristic symptom of IV is its association with pregnancy inguinal varicose veins or varicose veins in the legs.
Instrumental examination for varicose veins of the labia in pregnant women is limited to their sonography, as well as to ultrasound of the legs, because painful changes in the venous bed develop duringpostpartum period.
In most cases (about 80%), from the first days of childbirth, the symptoms of varicose veins during pregnancy begin to subside and subside 2-8 months after the birth of the baby. A complete return of the diameters of the flasks to their original values does not occur.
In 4-8% of women, IV does not go away after childbirth, and the disease progresses.
An interesting feature is the association between termination of breastfeeding or reduction in lactation volume with the disappearance rate of inguinal venous insufficiency in women. The shortened duration of lactation is accompanied by a decrease and disappearance of varicose veins and vice versa. This proves that perineal varicose veins during pregnancy are related to changes in hormone levels.
Treatment of perineal varicose veins during pregnancy
The basis of therapy for varicose veins during pregnancy is venous treatment. In the majority of fertile women, IV begins during the second and third trimesters. During this period, diosmin preparations can be used. The severity of the symptoms of the pathology is reduced by the fraction of micro-refined flavonoids. Itching is relieved by zinc patches and H1-histamine receptor blockers.
Low molecular weight heparin at prophylactic doses prevents venous thrombosis and pulmonary embolism (blood vessel blockage).
As an option for treating compression, tight stretchy underwear is prescribed using a latex pillow or gauze. It reduces the puffiness of the labia and the feeling of heaviness. Special compression bras for women with varicose veins of the vulva will help a lot.
If a complication develops, such as local thrombophlebitis, surgical treatment is necessary.
When a cluster of varicose veins is found on the genitals, the question arises about the method of delivery. Allows natural childbirth with varicose veins of the vulva. In contrast, the risks of surgery during a cesarean section are higher than those of initiating bleeding from painful vessels during delivery. This rarely happens. But with varicocele, cesarean section is often required.
Prevention of varicose veins of the labia
The main factor in the development of varicose veins in the groin is the fetus. It is difficult to name any method of prevention, given the fact that during pregnancy there are some limitations to many treatments. Some tips to follow:
- eliminate physical and static stress;
- follow a diet;
- perform therapeutic exercises, in which movements accelerate the flow of blood from the legs and lower pelvic organs;
- in case of interruption of the work of the veins, the presence of varicose veins before pregnancy, it is necessary to take drugs to soothe the veins, wear compression underwear.
An effective method of prevention is considered surgery of the ovarian veins, surgery of other pathologies associated with varicocele. This reduces pelvic vein congestion, reducing the risk of varicose veins of the labia minora.
Varicose veins of the vulva are common in women with varicose veins in the pelvis, legs or during pregnancy.
In order to improve the quality of treatment of patients with chronic venous disease, it is important to detect the disease, distinguish between methods of diagnosis and treatment of this pathology.