title: [A differentiated approach to management of small-pelvis varicosis in women].
abstract: In our clinic, we examined and treated a total of 32 women presenting with small-pelvis varicosis (SPV) and suffering from chronic pelvic pain appearing after prolonged static loads and physical activity, dysuric impairments, dyspareunia, and painful hypermenorrhoea. A Doppler ultrasonographic study and phlebography revealed SPV in them too. Appropriate treatment was carried out in a differentiated manner depending upon the stage of the disease and degree of clinical manifestations. Eighteen women with stage 1-2a SPV underwent comprehensive conservative treatment including venotropic preparations, microcirculation-improving agents, drugs influencing systemic enzymopathy, and physiotherapy. The remaining 14 women with stage 2b-3 SPV were subjected to roentgenovascular occlusion of the ovarian veins by means of sclerosing agents and Guianturco-type metal spirals. At 2-3 months after conservative and surgical treatment. 23 patients (72%) reported disappearance of pelvic pain; five women (16 %) were found to have their pain subdued; in four subjects (12.5%) pain did not disappear. During a 4-year period after treatment, 27 women (84%) had reportedly no dysuric events, five women (16%) at 2-2.5 years after treatment appeared to have developed exacerbations of chronic cystitis, two patients (6%) turned out to have periodically (2-3 times a year) been experiencing frequent painful urination. Besides, we carried out a morphological examination of the urinary-bladder walls on the post-mortem materials from 15 (unrelated) cases of accidental death, having revealed varisosis of the small pelvis. The findings obtained therein also strongly suggested that lingering impairment of the venous outflow from the small pelvis had led to development of a chronic inflammatory process in the urinary-bladder wall.
authors.forename: A I
authors.initials: AI
authors.lastname: Neĭmark
authors.forename: A A
authors.initials: AA
authors.lastname: Karpenko
authors.forename: N V
authors.initials: NV
authors.lastname: Shelkovnikova
authors.forename: T S
authors.initials: TS
authors.lastname: Taranina
mesh_terms: D000328:Adult; D001706:Biopsy; D004621:Embolization, Therapeutic / Q000379:methods*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply*; D010690:Phlebography; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D016896:Treatment Outcome; D014648:Varicose Veins / Q000175:diagnosis / Q000628:therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D012597:Sclerosing Solutions; D014665:Vasodilator Agents