Neĭmark A I, Shelkovnikova N V
Urologiia. 2012 Jul-Aug(4):20-4.
The results of the examination and treatment of 16 patients aged from 26 to 46 years with persistent urinary disorders and chronic pelvic pain due to severe pelvic varicose veins are presented. Using ultrasound with color Doppler mapping and venography of renal and ovarian vein for evaluation of condition of the venous system of the pelvis, the significant dilation of the internal iliac, ovarian and uterine veins with a pronounced decrease in blood flow in veins up to the stasis of blood, accompanied by flow turbulence and powerful backflow of renal blood through ovarian veins were found in all patients. According to uroflowmetry, there was a decrease in detrusor tone and a violation of evacuation capacity of the bladder. Evaluation of microcirculation using LDF allowed to diagnose congestive hemodynamic type of microcirculation. Scleroembolization for varicose ovarian vein with Gianturco coil and ethoxysclerol was performed in all patients. Positive therapeutic effect in the form of eliminating varicose pelvic veins, pain relieve, disappearance of persistent dysuria, and the remission of chronic cystitis was achieved in 86% of women. This intervention provided the normal outflow of blood from the pelvic veins, contributed to the normalization of uroflowmetry data and restoration of normal microcirculation in the urinary bladder.
本文介绍了16例年龄在26至46岁之间、因严重盆腔静脉曲张导致持续性泌尿系统疾病和慢性盆腔疼痛患者的检查和治疗结果。通过使用彩色多普勒超声以及肾静脉和卵巢静脉造影来评估盆腔静脉系统状况，发现所有患者的髂内静脉、卵巢静脉和子宫静脉均有明显扩张，静脉内血流显著减少直至血液淤滞，伴有血流紊乱以及肾血经卵巢静脉的强力逆流。根据尿流率测定结果，发现逼尿肌张力降低以及膀胱排空能力受损。使用激光多普勒血流仪评估微循环，诊断为充血性血流动力学型微循环。所有患者均采用Gianturco弹簧圈和乙氧硬化醇对卵巢静脉曲张进行硬化栓塞治疗。86%的女性患者取得了积极的治疗效果，表现为盆腔静脉曲张消失、疼痛缓解、持续性排尿困难消失以及慢性膀胱炎缓解。该干预措施使盆腔静脉血液正常流出，有助于尿流率数据正常化以及膀胱内正常微循环的恢复。
