[Diagnosis and treatment of atypical forms of varicose disease of pelvic veins].

Results of sclerotherapy of 59 patients with atypical forms of varicose disease of pelvic veins were analyzed. Four atypical forms of the disease were revealed: suprapubic (30.5%), vulvar (20.3%), perineal (25.5%) and gluteal (23.7%). Clinical, ultrasonic and phlebographic investigations have found that a pathological caval reflux of blood involving the internal ileac vein and its inflows underlie the development of atypical forms. An original technology of sclerotherapy of atypical forms of varicose disease by means of multiple repeated administration of sclerosant in minimal doses has been developed capable to cause but proliferative processes in the varicose vein walls. Elastic compression was not used. Varicose disease of the lower extremity veins was revealed in 36 (61%) patients with atypical forms of varicose disease of the pelvic veins. The volume of treatment of such patients was supplemented with operation of crossectomy, catheter sclerotherapy of the main trunk of the large subcutaneous vein and injectional sclerotherapy of its inflows. Results of treatment were assessed by clinical examination of the patients, duplex scanning and investigation of quality of life on the basis of self-appraisal of the patients according to recommendations of the international association of phlebologists. Excellent results were obtained in 32.6%, good - in 46.1%, satisfactory - in 19.1%, unsatisfactory - in 2.2% of the patients.

[Noninvasive diagnostics and treatment of pelvic organs blood repletion syndrome].

Analysis of complex clinical and ultrasound research in 78 women with chronic pelvic venous insufficiency was carried out. Left-side regional renal venous hypertension leading to valve insufficiency of left ovarian vein with extension of reno-ovarian blood reflux on racemose, uterovaginal, presacral, vesical and rectal venous plexuses was discovered in 100% of patients. Right-side cava-ovarian blood reflux was discovered only in 26.9% of patients and in combination with reno-ovarian lead to complete decompensation of venous outflow from pelvis. Three degrees of blood repletion of small pelvis organs were marked out. At first degree (61.5% of patients) complex drug treatment was carried out, at second degree (18%) - sclerotherapy, at third degree (20.5%) - operative excision of ovarian veins. Perfect results were seen in 35.9% of patients, good results - in 44.9% of patients, satisfactory - in 19.2% of patients. On basis of self-appraisal 80.8% of patients consider their life quality as completely recovered, 15.7% of patients - as improved, 3.5% of patients - without any changes.