Varicose veins (varices) is a disease accompanied by increased length, serpentine pathological tortuosity of the vein, irreversible cystic enlargement of its lumen, and valve insufficiency. The organs of the lower pelvis are involved in the varicose vein process. The mechanism of disease development is different. The doctor classifies the vaginal area, external genitalia, and internal genitalia as atypical locations.
General information about pathology
The process of blood flowing through the veins is carried out in this way, which creates the prerequisites for the development of blood stagnation and outflow under physiological conditions.
Varicose veins of the vulva (VV)-vasodilation of the external genitalia. This disease manifests in women with varicose veins in the pelvis and legs, as well as pregnant women. In 30% of cases, pelvic varices affect the perineum and vulva.
Due to the privacy of the location, the treatment of the disease started to be delayed. Women are very shy. In some cases, patients will not feel pain or discomfort. However, during pregnancy, varicose veins of the labia (not only during pregnancy) can cause complications: clogged veins with blood clots (thromboembolism), sexual sensory disturbances, perineal pain, psychological and emotional problems, and family conflicts.
The mechanism of pelvic vascular congestion has not been fully disclosed. The cause of the main form of the disease is called gonadal (ovarian) venous valve dysfunction. This can cause blood to flow back and increase the pressure on the venous nodes of the lower pelvis. Valvular insufficiency can be acquired or congenital. With age or pregnancy, the situation will get worse.
The secondary forms of pelvic organs VVV are related to gynecological diseases: endometriosis, pelvic organ tumors.
Since there are no specific symptoms in the course of the disease, the diagnosis of the disease is difficult. It is based on the results of ultrasound (ultrasound).
In order to distinguish between primary and secondary pathology, the Valsalva test is used during the ultrasound examination. It is negative for the secondary cause of pelvic varicose.
Labial varicose veins with VBT
To confirm the diagnosis of labial varicose veins, a doctor's examination is required. The symptoms of the disease are as follows:
- Genital varicose veins;
- Pain in the external genital area;
- Heaviness and burning sensation in the perineum;
- The perineum is swollen at the end of the day.
Chronic pelvic pain occurs less frequently (in 30% of cases).
After confirming the diagnosis, conduct research to determine the complexity of the pathological process and prescribe an appropriate treatment plan. Several events are being held:
- Examine the veins of the perineum and legs with ultrasound vascular scan-USAS;
- Ultrasound examination of pelvic blood vessels, including vagina, uterus, parameters, ovary, iliac, inferior vena cava and renal vein;
- According to the indications, multiple spiral computed tomography (MSCT), selective ovarian imaging and pelvic venography (SOFT) are performed.
Doctors refer to the characteristic of labial varicose veins as VBT, which means that the disease is steadily progressing and is accompanied by transformation of the pelvic veins.
Treatment of varicose veins of lower pelvis
Prescribe intravenous treatment based on symptoms and diagnosis.
In the complex drug therapy for the treatment of systemic chronic venous disease, non-steroidal anti-inflammatory drugs and intravenous drugs are prescribed.
Use antiplatelet drugs for medical treatment, use antihypoxic agents for intrapelvic block, use ultrasound for physical therapy, and perform therapeutic exercises. Antioxidants and enterogens are added to the treatment.
According to the indications, venous sclerotherapy-sclerotherapy is performed. The container is "sealed" with medication and laser. It stopped functioning. No special anesthesia is used in this process. It is performed in an outpatient clinic and produces cosmetic effects.
Because there are too many pelvic veins, the blood passes through the gonadal (ovarian) veins to expand and return, requiring surgery to remove the veins. In the case of enlarged labia minora varicose veins, remove it.
Varicose veins during pregnancy
Pregnancy is the first most common risk factor for the onset of VVV. Significant and sustained increases in progesterone concentrations in the first trimester reduce venous tone and aggravate impaired blood flow. In addition, VBT involving the perineum and vulva is related to the compression of the large veins in the retroperitoneal area (iliac and inferior vena cava) by the pregnant uterus.
The doctor recommends wearing tights during pregnancy.
Varicose veins of the vulva often occur on both sides. Signs of disease:
- Within 18-24 weeks of the first pregnancy, the vulvar veins increase significantly, starting from the 12th week of repeated pregnancy;
- Groin discomfort;
- Tugging, pain, dull pain in the pelvic area;
- Pain during sexual intercourse;
- Genital itching;
- Swelling of the genitals and perineum.
The signs of pathology progress as the pregnancy progresses. In addition to increasing the size of varicose veins, its compaction is determined by the third trimester of pregnancy. A characteristic symptom of IV is that it is combined with varicose veins in the groin or legs during pregnancy.
The instrumental examination of pregnant women's labial varicose veins is limited to ultrasound examination and ultrasonography of the legs, because the pain changes in the venous bed will degrade after delivery.
In most cases (approximately 80%), the symptoms of varicose veins during pregnancy begin to decrease from the first day of delivery and are minimized 2-8 months after the baby is born. It will not happen that the blood vessel diameter is completely restored to its original value.
In 4-8% of women, IV will not go away after delivery and the disease will progress.
An interesting feature is the relationship between the end of the feeding period or the decrease in breastfeeding and the disappearance of inguinal varicose veins in women. The shortening of lactation is accompanied by the reduction and disappearance of dilated veins, and vice versa. This proves that perineal varicose veins are related to changes in hormone levels during pregnancy.
Treatment of perineal varicose veins during pregnancy
The basis for the treatment of varicose veins during pregnancy is intravenous therapy. In the main part of fertile women, IV begins in the second and third trimester. During this period, diosmin preparations can be used. The micronized and purified flavonoids partially reduced the severity of pathological symptoms. Zinc paste and H1-histamine receptor blockers can relieve itching.
Preventive doses of low molecular weight heparin can prevent venous thrombosis and pulmonary embolism (blood vessel obstruction).
As an option for compression therapy, it is prescribed to wear tight elastic underwear with latex or gauze pillows. It can reduce the swelling and heaviness of the labia. The tights specially prepared for women suffering from vulvar varicose veins are very helpful.
If complications occur, such as local thrombophlebitis, surgical treatment is required.
When a collection of varicose veins is found on the genitals, there will be questions about the method of delivery. Varicose veins of the vulva allow natural childbirth. On the contrary, the risk of caesarean section is higher than that of painful blood vessel bleeding during delivery. This situation rarely happens. But for vaginal varicose veins, a caesarean section is usually performed.
Prevent labia varicose veins
The main factor in the formation of inguinal varicose veins is pregnancy. Considering that there are many restrictions on many treatments during pregnancy, it is difficult to name any prevention methods. Some tips to follow:
- Eliminate physical and static pressure;
- Diet
- Perform therapeutic exercises in which exercise accelerates the flow of blood from the legs and lower pelvic organs;
- In the case of interruption of venous work, there are varicose veins before pregnancy, it is necessary to take intravenous drugs and wear pressure underwear.
An effective prevention method is considered to be ovarian vein surgery, as well as surgery for other diseases related to varicose veins. This reduces pelvic venous congestion and reduces the risk of labial varicose veins.
Vulvar varicose veins are a common disease in women with pelvis, legs, or varicose veins during pregnancy.
In order to improve the quality of treatment for patients with chronic venous diseases, it is important to detect the disease and distinguish between the methods of diagnosis and treatment of the disease.