(Disclaimer: This article is for general use only, and the information in the following content has been processed to protect patient privacy)
Abstract: Pelvic varicose veins, also known as pelvic stasis syndrome, is one of the common gynecologic diseases, mostly seen in menstruating women. The patient in this paper is a 38-year-old woman who presented with recurrent lumbosacral pain, lower abdominal cramping, aggravated before menstruation, disrupted menstrual cycle and increased menstrual flow. After physical examination and vaginal ultrasound, pelvic varicose veins were confirmed. Through physical therapy + medication, the patient’s symptoms improved significantly and she was cured.
Basic information】Female, 38 years old
Type of disease】Pelvic varicose vein
Hospital】Guangzhou Huadu District People’s Hospital
Date of consultation】April 2021
Treatment plan】Medication (Blood Mansions and Stasis Capsules, Jisheng Kidney Qi Pills) + physical therapy
Treatment Period】Outpatients, treatment period is 1 year
【Treatment effect】The patient’s symptoms improved significantly and reached the purpose of healing
I. Initial consultation
On April 15, 2020, a middle-aged female patient came to the clinic with recurrent lumbosacral pain, lower abdominal pain, painful sexual intercourse, and menstrual disorders for the past 3 years, with a menstrual cycle of 25-35 days once, a menstrual period of 7-10 days, and heavy menstrual flow. Once thought to be chronic pelvic inflammatory disease, she was treated with oral gynecological Qianjin capsule, and her symptoms did not significantly relieve, so she came to our hospital for consultation. At the time of consultation, T: 36℃, P: 78 beats/min, R: 18 beats/min, Bp: 122/68 mm Hg. Appearance was normal development; there was no abnormality in cardiopulmonary auscultation as well as abdominal examination. Gynecologic examination showed normal vulvovaginal-cervical development, little vaginal discharge, a nuchal cyst was seen in the cervix, the uterus was retroflexed and posteriorly tilted with no significant pressure pain, and the bilateral adnexal areas were slightly thickened but without pressure pain. Vaginal ultrasound showed significant dilatation of the uterine veins and ovarian veins on both sides. On April 18, the patient underwent pelvic venography, which was consistent with pelvic varicose veins.
II. Treatment history
After the patient was seen, gynecologic examinations were completed and the patient was communicated with. The patient was treated mainly with medication, including oral Hematopoeia capsule, which has the effect of activating blood circulation and removing blood stasis. At the same time, oral administration of Jisheng Kidney Qi Pills, through the diuretic effect, can relieve the edema of the pelvic tissues and reduce the clinical symptoms. Physiotherapy is also combined with physiotherapy, which is mainly performed in the patient’s chest and knee position once a day in the morning and once in the evening for about 15 minutes each time; and assisted with anal retraction exercises twice a day (once in the morning and once in the evening) for 30 strokes each time. In addition, patients should be advised to sleep at night in the lateral position, with the head low and feet high.
III. Treatment effect
After a full year from the initial outpatient treatment, from daily treatment in the chest and knee position to oral diuretics and intermittent administration of Blood Mansions and Blood Stasis Capsules, the patient’s clinical symptoms were significantly relieved, and the recurrent lumbosacral pain and lower abdominal pain symptoms were significantly reduced. There is no more pain during sexual intercourse, menstruation basically returned to normal, the volume of menstruation will not be as much as before, and menstruation clears in about 7 days. After the clinical comprehensive treatment, the symptoms are obviously improved and the purpose of cure is achieved.
IV. Notes
Through the regular follow-up of the patient, we learned that the patient’s recovery is good and the symptoms basically disappeared, so we are glad that the disease has a good regression. However, we should not be careless, the disease is not easily cured, patients should adhere to the medication at home, avoid stopping it on their own, and seek timely medical review. In life, keep the bowels open and eat more fresh fruits and vegetables. If constipation symptoms occur, it is recommended to take a spoonful of honey flushed with water or eat more bananas every day to improve constipation symptoms. Reduce prolonged squatting, standing or prolonged sitting in daily life. Patients can use their own palms to massage the lower abdomen and sacrococcygeal joints to promote local blood circulation and improve the symptoms of pelvic stasis.
V. Personal insight
Pelvic varicose veins and chronic pelvic inflammatory disease have similar symptoms, so they are usually mistaken for chronic pelvic inflammatory disease, and the effect of anti-inflammatory treatment is not good, leading to irritability and depression, etc. Therefore, if patients have recurrent lumbosacral pain, lower abdominal pain, painful sex and menstrual disorders, they should not wait for 3 years to come to the clinic, as the patient in this article did, but should have pelvic angiography as early as possible for diagnosis and Active medication should be administered. The patient in this article has relatively mild pelvic varicose veins, so the symptoms are significantly relieved by physical therapy and medication, but if the pelvic varicose veins are severe, surgery is needed.