PELVIC VEIN INSUFFICIENCY (INCOMPETENCE)

 

Pelvis is the name given to the lower abdomen in medical language. Pelvic vein insufficiency refers to the valve failure of the veins in this region. The vein which is most commonly involved in the pelvic region is the left gonadal vein. The left gonadal vein is the vein located between the left kidney and genital organs and transmits the venous blood of organs such as testes, ovaries to the left kidney and then to the lung. Gonadal vein is also called spermatic vein in men and ovarian vein in women. When insufficiency begins in the gonadal vein, the venous blood, which should normally flow upwards into the lung, flows in the opposite direction, ie towards the ovary or testis. This may lead to varicocele in men and "pelvic congestion syndrome" in women. Varicocele may cause pain and infertility in men, and pelvic congestion syndrome may cause abdominal distention in women and pain during sexual intercourse.

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As a result of gonadal vein insufficiency, varices that form around the ovary and testis may descend from the inner part of the groin towards the legs and cause leg varicose veins. This condition, which is more common in women, starts with painful varices, especially in the vulva and vagina, and may progressively lead to varicose veins. The most typical finding in such patients is the increase in varicose vein pain in the legs during menstruation. The ideal treatment for gonadal vein insufficiency is the occlusion of the left gonadal vein, with an angiography procedure called embolization. Subsequently, varicose veins in the vagina and legs should be treated by other non-surgical methods such as laser and foam.

 

 

 

 

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In addition to gonadal veins, pelvic vein insufficiency may also occur as a result of failure of other veins in the pelvic region. These veins may originate from the right internal iliac vein or the main femoral vein. In some cases, it may not be clear which vessel is causing the failure.

 

Pelvic vein insufficiency is a very common disease in Middle East, Asia and Africa due to both the genetic predisposition and the high number of pregnancy, but it is usually underdiagnosed. The most important findings are the presence of varicose veins in the vulva-vagina and groin and pain in the legs during menstrual bleeding. Color Doppler ultrasound should be done very carefully for those who have such complaints. Unfortunately, due to insufficient color Doppler ultrasound examinations, the majority of patients with pelvic vein insufficiency cannot be diagnosed and therefore do not receive adequate treatment.

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 Video: Why is Doppler ultrasound so important in varicose veins?