Pelvic varicose veins

　　The main population with pelvic varicose veins is women, especially pregnant women and middle-aged women. Compared with other organs' veins, the veins of the pelvis are thinner, lack valves, and are connected with the venous plexus of the reproductive organs, bladder, and rectum. Once blood reflux is slow and easy to be blocked, varicose veins can form.

　　The main manifestation of pelvic varicose veins is widespread chronic pain, extreme fatigue, and some symptoms of neurasthenia. Among them, chronic lower abdominal pain, low back pain, unpleasantness, extreme fatigue, excessive leukorrhea, and dysmenorrhea are the most common, almost more than 90% of patients have varying degrees of the above symptoms. So-called chronic pain refers to various forms of pain lasting for more than half a year, with a frequency of not less than 5 days a week, and not less than 4 hours a day. In addition, patients often have excessive menstrual bleeding, premenstrual breast pain, premenstrual defecation pain, bladder irritation symptoms, and vaginal and anal prolapse pain. These symptoms are worse in the afternoon, evening, or after standing, and more severe before sexual intercourse and before the onset of menstruation.

　　Pelvic venous congestion, poor blood circulation, can cause lower abdominal pain, increased leukorrhea, and can also appear symptoms of urinary frequency and urgency, such as hemorrhoids. The main population with pelvic varicose veins is women, especially pregnant women and middle-aged women. Compared with other organs' veins, the veins of the pelvis are thinner, lack valves, and are connected with the venous plexus of the reproductive organs, bladder, and rectum. Once blood reflux is slow and easy to be blocked, varicose veins can form.

　　Pelvic varicose veins with blood stasis, poor blood circulation, and can cause related symptoms. The methods of preventing and treating the disease, in addition to external and artificial factors, should pay attention to postpartum care, strengthen the exercise of abdominal muscles, pelvic floor muscles, and lower limb muscles.

　　1. Pay attention to bed rest after childbirth and avoid long-term squatting, standing, and sitting positions.

　　2. Keep the bowels smooth. If constipation occurs, take a spoon of honey in the morning and evening, and consume foods that help treat constipation.

　　3. Perform anal contraction exercises, 5-6 times a day, each contraction 10-20 times.

　　4. The knee-chest position can be used for exercise, that is, the chest is close to the bed, the buttocks are raised, and the thighs must form a right angle with the calves. Exercise twice a day, each time for about 15 minutes.

　　5. When lying in bed, it is best to adopt a lateral position. If possible, lying in bed can adopt a head-down, feet-up position.

　　The examination of pelvic varicose veins includes the following contents:

　　1. X-ray pelvic venography is a reliable method for diagnosing pelvic venous congestion syndrome, but it has certain injuries and is limited by some conditions. Ultrasound examination is simple and easy to perform, especially CDFI can indicate the diagnosis of pelvic congestion syndrome at an early stage, and can clearly show the severity, range of venous congestion, and can be graded.

　　2. Abdominal ultrasound can also be used to distinguish it from other pelvic vascular diseases. Ultrasound examination is the first choice for the diagnosis of pelvic congestion.

　　Patients with pelvic varicose veins should pay attention to their diet:

　　1. It is advisable to choose light food, avoid cold, spicy and刺激性 foods.

　　2. Supplement nutrition, eat more high-calorie, high-protein, easy-to-digest foods such as soybeans, green peas, peanuts, tofu, soy milk, wheat gluten, animal liver, fish, walnuts, melon, oatmeal, etc.

　　3. It is advisable to drink more water and eat semi-liquid foods such as rice porridge, lotus root powder, grape juice, apple juice, soda, hawthorn syrup, etc.

　　The treatment of pelvic varicose veins includes conservative treatment and surgical treatment, as follows:

　　First. Conservative Treatment

　　1. For mild cases, the patient should adopt a side prone position with the affected side up during the afternoon nap and at night, and appropriate physical exercise should be done at the same time. For severe cases, the chest-knee position should be added, twice a day, for 10-15 minutes each time.

　　2. Diuretics can be used to reduce tissue edema, which can often alleviate premenstrual congestion symptoms.

　　3. Uterine pessaries can be used for patients with uterine prolapse or obvious pelvic floor relaxation.

　　4. For those whose symptoms worsen when standing, periodic rest can be taken to alleviate pelvic venous congestion, and sitting work can also be changed.

　　Second. Surgical Treatment

　　Applicable to a few selected cases, it is advisable to take a cautious attitude, and the surgical methods include:

　　1. Round ligament suspension and sacrotuberous ligament shortening: Applicable to large, retroverted uterus, younger patients, who want to retain the uterus and appendages. This operation is rarely used.

　　2. Broad ligament laceration fascial transverse repair: Applicable to severe pelvic congestion due to laceration of the bottom fascia of the broad ligament in patients who still need to give birth.

　　3. Total abdominal hysterectomy with附件切除术: Applicable to women over 40 years old or near menopause, the varicose veins of the uterus and ovarian veins should be removed as much as possible.

　　4. Nerve section: Sigmoid nerve section or section of the uterosacral ligament and cervix nerve plexus may be occasionally performed.