A Current View on the Problem of Varicose Veins of the Pelvis (Review)

Etiopathogenesis and diagnosis of varicose veins of the pelvis or pelvic varicose veins have been considered from the present-day perspective. Despite a high prevalence of this pathology it is still insufficiently explored.

One of the main symptoms of the disease is a chronic pain in the lower abdomen lasting over six months and suffered by women of various ages. In the foreign literature, it is commonly called pelvic congestion syndrome, in the Russian literature — varicose veins of the pelvis.

Varicose veins of the pelvis can arise due to aplasia or venous valve incompetence, the genetic origin of the illness is confirmed by numerous scientific investigations. The second main cause is venous obstruction. The emergence of the disease is also promoted by the specific anatomy of the venous outflow from the small pelvis: the right ovarian vein opens into the inferior vena cava, and the left ovarian vein to the left renal vein. The normal angle between the aorta and the superior mesenteric artery is about 90°, and in case of the angle reduction aorto-mesenteric compression of the renal artery takes place.

One of the disease complications is thrombosis of the intrapelvic venous plexuses and the ovarian veins which occurs most commonly in the period of pregnancy or after delivery, and less rarely after various surgical interventions in the small pelvic organs.

The knowledge of etiopathogenesis principles will facilitate differential diagnosis of chronic pelvic pain in patients with varicose veins of the pelvis.

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