Pelvic venous congestion syndrome
Pelvic venous congestion is a condition of the venous system in the pelvis, a condition that most often affects females due to specific anatomical features.
What is pelvic venous congestion
Pelvic venous congestion is due to varicose veins present in women in the internal ovarian and iliac veins (left and right).
The pathology is less common in men, the main diseases due to pelvic venous incompetence being varicocele (venous dilation of the spermatic cord veins), haemorrhoids, impotence and varicose veins in the lower limbs (dilatations of the superficial veins).
Causes
The drainage of blood through the internal iliac from the anus, perineum, ovaries, external genitals (vulva) and internal (vagina) is slow and requires proper functioning of the venous valve system to function properly. Blood stagnation is due to the inability of the valves in the internal venous wall to function, with the main consequence being the appearance of dilatations (pelvic varicose veins) with pressure on the internal pelvic organs: bladder, intestines, vagina and pelvic girdle. Pelvic venous reflux occurs mainly in orthostatism or the "sitting" position, as a result of the action of gravity on the blood flow.
What are the specific symptoms of pelvic congestion syndrome
In most cases, the venous disease manifests itself during the fertile period, under hormonal action. We find a low incidence in girls before puberty or in menopausal women. The main symptoms of pelvic venous congestion are:
- Pelvic pain or heaviness;
- Urinary incontinence due to pressure of venous dilatation on the bladder;
- Irritable bowel syndrome secondary to rectal damage;
- Dyspareunia (the presence of intermittent or permanent pain during penetration).
Self-assessment
The symptoms of pelvic congestive syndromes can be improved by changing the patient's position so that an improvement in the general condition has been observed with a decrease in the feeling of heaviness in the lower abdomen when adopting supine (the patient lies horizontally) or with an elevated pelvis, so that the pelvis is above the thorax).
If the clinical manifestations worsen during the day when the patient is standing and is active but are reduced in the morning after a night's rest, probably we deal with the congestive venous syndrome.
Treatment of pelvic varicose veins
Treatment for pelvic varicose veins is EVP pelvic venous embolization by sclerotherapy, a safe and effective method with favourable long-term results. The location of venous pathways in the vicinity of vital organs such as the ovaries, intestines, uterus or bladder contraindicates the use of conventional laser treatments that can cause local burns through the emitted heat.
The procedure involves placing a catheter under Doppler ultrasound guidance, in the affected vein, followed by the introduction of a sterile sclerosing substance in the form of foam that produces a controlled inflammatory reaction and stops blood flow. The vein often becomes invisible and disappears, being resorbed over time by the body. The discomfort during sclerotherapy is minimal, and the result obtained after venous obliteration with foam is usually permanent.