Pelvic congestion syndrome

Overview This syndrome is the most important symptoms lower abdominal pain, low back pain, sexy unhappiness, extreme fatigue, stasis dysmenorrhea and premenstrual breast pain. Pain is usually a few days before menstruation aggravated ebb after the first or second day of mitigation, the pain continued in a few cases. Pain is often the patient is standing for some time, and running, jumping, or sit down when suddenly increased after sexual intercourse, aggravated, heavy afternoon than the morning. Deep intercourse pain is a common and do not want to talk about the disease. In addition to pain, the other as leucorrhea, constipation, bladder pain, irritable temperament, is also a common symptom of the syndrome. Married most of the patients, most of the symptoms of a particular childbirth or abortion shortly after the start. Most common in 25-40-year-old women, and very few in premenopausal and postmenopausal was never on. Gynecological examination, premeditated, cervix and uterus after fornix may have tenderness, annex area tenderness, flu seems to be thickening; After parametrial organizations tenderness also styles. Make any cause pelvic vein outflow pelvic impeded or obstructed factors, can be induced into pelvic venous stasis. And men compared to women in the cycle of sexual pelvic anatomy, hemodynamics and mechanical aspects are quite different. Is easily formed the basis of pelvic bleeding. 1, the female pelvic anatomy factors cycle characteristics, the main vein of increase in the volume and structure weak. Medium pelvic vein as the uterine vein, vaginal vein and ovarian vein, usually two-three vein with a same name artery, vein or even ovarian up to 5 ~ 6. Formation plexiform venous plexus, bending both sides of the rear body of the uterus, pelvis until their fate before flowing through the formation of a single ovarian vein. In the uterus, fallopian tube, ovarian vein there are many support the tubal mesooviduct, have uterine and ovarian vein vein anastomosis, and forming a ring of venous circulation, with the lateral line ovarian venous plexus. Originated in pelvic organ tissue, muscle and serosa of venous plexus, a collection of more than two vein, the flow of coarse iliac vein. Pelvic vein is on the increase, is to adapt to the slow movement of pelvic vein needs. Pelvic veins than other parts of the body of the thin vein wall, the lack of fascia from the sheath, no valve, lack of flexibility, Passing through the pelvic osteoporosis among the connective tissue. So it is likely that expansion and the formation of numerous bending venous plexus. Pelvic only a small vein in it before entering the large veins have valves, and some women also often by the valve dysfunction. These characteristics make the pelvic viscera venous system, like a network linked to the water of the swamp, can accommodate a large number of rapid inflow of arterial blood. In addition, bladder, genitals and rectum three venous plexus of the same with each other. Due to the lack of valve, the one among the three any obstacles to the circulation system, may affect the other two systems. (Figures 3, 4) Figure 3 pelvic venous plexus profile (6 show the location of venous plexus) Figure 4 bladder, Vaginal hysterectomy and the iliac vein and the vein (intravenous showed reproductive system along the trunk after two highly cited the trend) in pots IVC these anatomical features on the basis of the following as further relevant factors, it contributed Pelvic Congestion Syndrome. and the performance of various clinical signs. Second, some physical factors of the patients due to physical factors, vascular wall notable weak, and less elastic fibers, elastic poor, easily formed venous stasis and varicose veins. Even if the first pregnancy, usually did not engage in prolonged standing or sit-ins, it could lead to lower limb and / or pelvic varicose veins and pelvic congestion syndrome. 3, the mechanical factors of different mechanical factors proven to affect pelvic blood flow, thereby changing the local vascular pressure. Intravenous more affected. (1) Position : long standing or sitting workers, pelvic vein pressure sustained higher easy to become Pelvic Congestion Syndrome. Such patients often complain stayed behind long after the station under abdominal pain, low back pain increase, leucorrhea and menstrual volume increase of the volume, and after a rest, often relieve symptoms. Moreover, accustomed to sleep supine position, due to the gravity uterus and bladder filling the role so uterus backward shift, also affect pelvic venous outflow. From the mechanical point of view, habitual supine sleep, most of pelvic vein below the location of the inferior vena cava. is not conducive to the pelvic vein outflow pelvic, and lateral or side-prone sleep position is beneficial to the pelvic vein outflow. (2) after dumping uterus : Uterine after dumping in gynecologic patients accounted for 15 ~ 20%, after maternal may even higher. 100 years ago, it had been thought that after the uterus caused by the dumping is the cause pelvic symptoms, and often held Palace suspension. To the beginning of this century, people have gradually realized that the majority of the uterus after the dumping has no symptoms and require no treatment. Only part of the uterus after dumping the pathogenic role of pain. But many doctors believe that there are few activities in the womb after dumping may lead to pelvic pain. After dumping uterine, ovarian vascular plexus with the uterine body bending down in the sacral concave on both sides, so that increased venous pressure, return to be affected, resulting in venous stasis in the state. If there are further supine sleep habits, the passage of time can lead to pelvic congestion syndrome. (3) early marriage, early childbearing and motherhood frequent : during pregnancy because of the large number of male and progestin, coupled with the increase of uterine right uterine vein around the oppressed, can cause uterine peripheral vein expansion. (4) constipation : constipation affect venous return to the rectum, rectum and uterus and vagina vein each other. Hemorrhoids Cong congestive would inevitably lead to congestive Cong vaginal hysterectomy, the habits are prone to constipation pelvic bleeding. (5) fascia broad ligament rupture broad ligament rupture makes constructed weak and lacks flexibility, inherent lack of vascular sheath of the veins but also lose support, and formed varices, after reversing uterus. (6) tubal ligation : With the extensive family planning, Tubal ligation is the most common implementation of the family planning surgical one. In recent years, many magazines published successively emerged after the ligation of pain, menstrual disorders, dysmenorrhea, and other secondary complications reported. Tubal ligation is a minor surgical operation, theoretically speaking, it was entirely possible to not have these complications. But in reality, some women ligation some patients so painful, difficult medical complications. 4, autonomic disorder Despite these kinds of causes and Anatomy Department lesions, But so far that many workers Obstetrics and Gynecology Pelvic Congestion Syndrome certain symptoms such as : depression, sad mood, irritability, fatigue and easy chronic pain, low back pain, the sexy slow, in large measure patients with the mental state. Probably due to autonomic dysfunction results. 5, the other was found on the clinical uterine fibroids and chronic pelvic inflammatory disease (especially of tubo-ovarian cyst formation). lactation amenorrhea, and severe in patients with cervical erosion, doing pelvic venography, Some also showed pelvic venous stasis; and long-term depression, chronic disease, insomnia and other spiritual impact, and by the early estrogen, fluctuations in the level of progesterone, a similar pelvic congestion syndrome symptoms. The former of the pelvic venous stasis picture can be seen as a complicated change; After one of the categories can be considered as Pelvic Congestion Syndrome aggravating factors.