Pelvic varicose veins in women

What are pelvic varicose veins?

They are venous dilatations of the genital veins (uterus, ovaries) and/or developed from veins that drain the other pelvic viscera or the pelvic wall. There are two forms of pelvic varicose veins. - The first, asymptomatic, are harmless and should not be treated. - The latter are responsible for clinical signs that appear more frequently after the second pregnancy in rather young women (under 40 years old).

What are the suggestive clinical signs?

  • The so-called pelvic congestion syndrome which always includes chronic pelvic pain that varies in intensity, but is sometimes very disabling, decentralized, or localized, aggravated by prolonged standing, at the end of the day and the week before menstruation. It is frequently associated with painful periods, and pain during or immediately after sexual intercourse. Undetected, these disorders lead to anxiety, depression, relationship problems in couples, and "frigidity".
  • Varicose veins of the lower limbs. 10% of varicose veins in the lower limbs originate from the pelvis. In this context, the treatment of pelvic varicose veins must precede the treatment of varicose veins of the lower limbs to prevent their recurrence.
  • Neuralgia, a rare pathology that causes intense pain, whose unrecognized cause leads these women to psychiatric and pain centers.

How to diagnose these pelvic varicose veins?

The diagnosis is discussed during consultation and clinical examination after which the specialist requests a pelvic and perineal ultrasound, and a pelvic MRI. If there are symptomatic pelvic varices,  a pelvic phlebography, which is a painless examination that does not require hospitalization, should be carried out, This is the only exam capable of establishing a pelvic map that helps decide what to do next.

What is the treatment?

It depends on the result of the phlebography. Pelvic varices can now be treated by embolization. The technique consists of gluing the varicose veins with a synthetic glue (a technique used for more than 30 years in the treatment of cerebral vascular malformations) or by obliterating them using coils, platinum-fiber springs equivalent to the clips used in surgery. Complications are very rare. The results are remarkable if the indications are well defined and treatment is complete. Pelvic varicose veins, the cause of a sometimes very disabling pathology, and a source of costly chronic medicalization, can and should now therefore be diagnosed and treated.

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