• Pelvic venous insufficiency in men

Introduction

Pelvic venous insufficiency (English. Pelvic Venous Insufficiency, PVI) is a condition that most commonly affects women of childbearing age, but not exclusively. Studies and our own - already more than 15 years - observations indicate that PVI affects approximately 12-15% womenand in the female population with chronic pelvic pain (English. Chronic Pelvic Pain, CPP), this percentage rises up to 30-40%. Pelvic venous insufficiency is characterized by excessive dilation of venous trunks and branches within the pelvic and/or abdominal drainage area, leading to retrograde blood flow, its excessive accumulation in organ or peri-organ reservoir venous vessels (e.g., parametrial venous plexuses), and pathological stasis. This cascade of adverse phenomena leads to the development of a variety of symptoms, such as chronic pelvic pain, a feeling of heaviness, painful menstruation, or discomfort during intercourse. Untreated insufficiency can also result in the appearance of varicose veins in unusual locations, including the labia, perineum, or the posterior surface of the thighs, significantly reducing the patients' quality of life. symptomsof which the most common are: lower abdominal pain, painful, prolonged and heavy periods, heaviness of the legs during menstruation or pain during intercourse.

Pelvic venous insufficiency is often unrecognised (especially during routine gynaecological visits) or confused with other pathologies, such as endometriosis external- and intrauterine (so-called adenomyosis). This delays the implementation of appropriate treatment (sometimes by 10-15 years!), leads to incorrect treatment decisions venous disease of the lower limbs, significantly worsening women's quality of life and, consequently, reducing the chances of conceiving offspring.

In the context of misdiagnosis of pelvic venous insufficiency, it is worth noting its similarities with endometriosis. Both diseases can present with similar symptoms, which makes diagnosis difficult. Research indicates that endometriosis affects approximately 10% of women of reproductive age. However, in the case of women with chronic lower abdominal pain, the incidence of endometriosis can be significantly higher. Given that pelvic venous insufficiency occurs in as many as in over 30% of women with chronic pelvic pain, the possibility of both conditions coexisting must be taken into account. Our daily practice shows that these diseases quite often overlap, and the pain symptoms they cause have an exceptionally bothersome nature and are referred to as endo-venous. Pelvic venous insufficiency caused by abnormal venous anatomy usually presents symptoms several years earlier than endometriosis (it is detected in girls and young women aged 12-19). Furthermore, the spectrum of symptoms associated with pelvic venous insufficiency is much wider than in the case of typical endometriosis.

Pelvic venous insufficiency, pelvic venous disease
or passive pelvic congestion syndrome?

We phlebology there are several related terms, the meaning of which can be somewhat confusing for both Patients and medical staff. Below we explain the key differences and interrelationships between these terms, the understanding of which is quite important in terms of the diagnosis and treatment of Patients presenting with suspected pelvic venous insufficiency.

Pelvic venous insufficiency (English. PVI) is a term used to describe the phenomenon of abnormal functioning of the veins in the pelvic region. It is unfortunately an oversimplification of the reality, as a significant proportion of cases of pelvic venous insufficiency originate in the epigastrium, within the drainage of the left ovarian vein (LOV(LOV, Latin: vena ovarica sinistra), which typically drains into left renal vein (LRVleft renal vein).

The left ovarian vein – named many years ago at the Phlebology Clinic „the vein of love" (from the word LOVE (English. Left About thevarian VE– this is the most common "culprit" behind pelvic venous insufficiency and lower limb venous insufficiency in women. Especially within the population of women who have given birth or those who engage in excessive strength training (so-called post-exertional venous insufficiency). To drugie zjawisko nabrało znaczenia w ostatnich kilku, w których takie aktywności jak ćwiczenia ze sztangą czy zajęcia typu crossfit stały się wyjątkowo popularne, szczególnie w populacji kobiet młodych, jeszcze nierodzących.

Pelvic venous disease (Pelvic Venous Disease, PeVD) - is a broader term referring to the entire spectrum of pelvic venous disorders with concomitant symptoms for this disease. The clinical symptoms of PeVD result from venous reflux or obstruction within the interconnected veins of the abdomen, pelvis and lower limbs.

About the passive pelvic congestion syndrome (Pelvic Congestion Syndrome, PCS) we refer to when a patient has specific symptoms resulting from a diagnosis of pelvic venous insufficiency. By definition, PCS is characterised by:

• Chronic Pelvic Pain, CPP) lasting more than six months;
• an increase in discomfort when standing, sitting or during exertion or lifting;
• dyskomfortem lub bólem w czasie współżycia (tzw. dyspareunia);
• bólem podbrzusza w czasie miesiączki lub tuż przed;
• coexistence of varicose veins in the pelvis.

It should be remembered that PCS is not diagnosed on ultrasound or radiological imaging (CT or MR). The diagnosis of the syndrome is always clinical diagnosis, based on the presence of characteristic symptoms and confirmed by imaging studies such as Doppler ultrasound of the pelvic and abdominal veins, as well as venographic studies like MRV or CTV. It happens that patients with an ultrasound and radiological diagnosis of Pelvic Venous Insufficiency, PVI, have venous insufficiency of the lower limbs secondary to PVI with typical limb symptoms, but no lower abdominal pain symptoms. In such a patient, then, full-blown PCS should not be diagnosed, but only chronic venous disease of lower limbsIn such situations, symptoms occur within the lower limbs rather than in the pelvic area.

To sum up:

PeVD (Pelvic venous disease) - is the broadest term, encompassing all pelvic conditions with a venous background;
PVI (Pelvic venous insufficiency) - is a haemodynamic disorder that can lead to venous stasis in the pelvis and produce (but not necessarily) the typical symptoms of PCS;
PCS (Passive pelvic congestion syndrome) - is a set of symptoms that follow PVI;
Pelvic varices - are the anatomical manifestation of the PVI (the most common of which are varicose veins of the parametria).

Factors that increase the risk
the occurrence of pelvic venous insufficiency

• unfavourable anatomical conditions in the structure of the venous system
• postural defects (e.g. scoliosis)
• strength training in interview
• chronic constipation
• prolonged sitting or standing

• number of pregnancies and deliveries
• family and genetic background
• hormonal imbalances (especially oestrogen)
• history of gynaecological and pelvic surgery
• high rise

Mechanism of pelvic venous insufficiency

Pelvic venous insufficiency is a complex disorder of the venous system that particularly affects the female sex. In the case of pre-pregnancy pelvic venous insufficiency The following factors play a key role in its formation:

• anatomical abnormalities of the venous system (e.g. hypoplasia of the left renal vein);
• genetic (family) predisposition;
• overuse of forceful physical exercise (heavy weight training).

The most common form of pelvic venous insufficiency is secondary form due to previous pregnancies and childbirths. Mid-pregnancy hormone surge (estrogen levels in a single pregnancy can increase by up to 50-100 times), an increase in circulating blood volume (increases by approximately 30-50%) and pressure on the pelvic veins, renal veins or inferior vena cava, are factors that directly affect the condition of the main venous axes and reservoir veins located around the reproductive organs.

Is did you know that?

In the initial diagnosis of pelvic venous insufficiency, expert Doppler ultrasound examination of the abdominal, small pelvis and lower limb veins performed standing and lying down is crucial.

PhD Cezary Szary

About the passive pelvic congestion syndrome (Pelvic Congestion Syndrome, PCS) we refer to when a patient has specific symptoms resulting from a diagnosis of pelvic venous insufficiency. By definition, PCS is characterised by:

Post-exertional venous insufficiency

Post-exertional venous insufficiency (ang. Exercise-Induced Pelvic Venous Insufficiency) is a medical term introduced into use by doctors of the Department of Phlebology over a decade ago. After many years of comprehensive diagnostic evaluation of our patients, analyzing their lifestyle habits, as well as the rapid change in physical activity trends (the gym craze), we have noticed that more and more young women are coming to us with pelvic venous insufficiency related to excessive strength training. These are women aged 18-25 (nulliparous) who, during a Doppler ultrasound in both standing and lying positions, present an overall dilation of the venous bed in the abdomen and pelvis. In these individuals, venous insufficiency in the legs develops exceptionally quickly.

Even 6-12 months of intense performance of exercises such as: barbell squats (squatting with a barbell), dźwiganie sztangi z rwaniem or heavy deadlifts, accompanied by improper breathing and excessive load, leads to post-exertional pelvic venous insufficiency.

It is beyond dispute that sensible, regular, and correctly performed physical activity—such as swimming, yoga, pilates, stretching, nordic walking, or resistance band exercises—is beneficial for the venous system. However, it is important to remember that not all activities are created equal. Why is this the case? You can read about it below

The mechanism behind the development of post-exertional pelvic venous insufficiency

It is important to remember that certain sports activities, especially strength training, can lead to a significant increase intra-abdominal pressure (ang. Intra-Abdominal Pressure, IAP). This always has a negative impact on our venous system, which is a completely different system than the arterial system.

The human venous system is characterized by low pressure, very high extensibility, and high susceptibility to compression.

Under resting conditions, intra-abdominal pressure in healthy individuals ranges from 0 to 5-8 mmHg. During physical activity, this pressure increases, reaching various values depending on the type of exertion:

• running: 10-20 mmHg
• tennis: 15-25 mmHg (serving 50-100 mmHg)
• cycling: 15-30 mmHg
• strength training:
  • martwy ciąg: 50-170 mmHg
  • snatch (barbell): up to 160-180 mmHg
  • barbell squats: 100-200 mmHg

Long-term, rapid, and repetitive periods of elevated intra-abdominal pressure can lead to the development of symptomatic pelvic venous insufficiency and the resulting secondary venous insufficiency of the lower limbs. In these individuals, the typically occurring heaviness or pain in the lower abdomen, pelvic floor, or legs intensifies after exercise. Over time, this leads to an overload of the deep venous system in the legs and the development of varicose veins in the superficial venous system. These are visible on the thighs or lower legs. Post-exertional venous insufficiency is difficult to treat due to the long-term and systemic dilation of the venous bed. We often see it in weightlifters, gym enthusiasts, tall athletes training with heavy loads (e.g., volleyball or basketball players), rowers, or boxers.

Symptoms of pelvic venous insufficiency

SUBJECTIVE SYMPTOMS

• colicky pains on the left side of the body in the kidney projection (e.g. after running)
• a feeling of fullness and distension in the abdomen, frequent abdominal bloating
• chronic lower abdominal pain, worsening on standing and after exertion
• lower abdominal and/or back pain during the first days of menstruation
• painful, prolonged (>7 days) and heavy periods
• pain or discomfort during intercourse (dyspareunia)
• bladder hypersensitivity
• symptoms of venous vulvodynia (spontaneous burning of the vulva, vestibular area as a result of venous stasis)
• heaviness of the legs during the first days of menstruation
• feeling of heavy legs after exertion
• perimenopausal leg swelling (sometimes painful)
• paroxysmal pain in the casts of the adnexa, reproductive organs (effect of thrombophlebitis of the venous plexuses of the parametria).

ADDITIONAL SYMPTOMS

• vulvar and perineal varicose veins discernible by the patient
• venous insufficiency of the lower limbs (including varicose veins) originating from the pelvis, secondary to pelvic venous leaks
• dilation within the posterior limb outflows (telangiectasias, reticular veins) descending into the popliteal fossa areas
• Anaemia (anaemia) in blood tests.

Diagnosis and recognition of female pelvic venous insufficiency

The diagnosis of pelvic venous insufficiency is based on a comprehensive clinical assessment, as well as the use of Doppler ultrasound and advanced imaging studies. In the clinical phase, we focus on gathering a medical history regarding all relevant symptoms, including "venous" ones. It is important to evaluate visible signs of venous insufficiency, such as: varicose veins of the intimate area (usually located in the perineum, vulva or inguinal canals) or atypical varicose veins of lower limbs. Imaging studies, such as expert Doppler ultrasound, magnetic resonance venography (MRV), or computed tomography venography (CTV), allow for the visualization of the anatomical structure and functional disorders within the venous system of the abdominal cavity, pelvis, and lower limbs.

Ultrasonografia dopplerowska żył

Doppler ultrasound of the veins is a non-invasive examination, widely available and, compared to MR venography, relatively inexpensive. Its role is to assess the anatomy and morphology of vessels and organ structures. The key feature of Doppler ultrasound, however, is the possibility to examine the flows intravitally and thus assess the capacity of the venous vessels in different breathing situations, as well as in different positions of the patient's body. As is well known in the study of the venous system, these are key issues.
Problems with ultrasound of the venous system arise when it needs to be assessed holistically. Such an examination covers the venous system from the feet up to the right atrium of the heart. Unfortunately, in Poland, most often only the veins of the lower limbs are examined, "forgetting" that the venous system begins, among other things, in the legs and ends in the heart. There are still too few specialists who have the necessary experience in this type of examination. It should be remembered that the specialists who perform this type of examination should also be able to assess other pathologies (e.g. endometrial lesions), which are quite common in women with suspected Pelvic Venous Insufficiency, PVI.

The secrets of pelvic and abdominal vein Doppler ultrasound examination

Discover the secrets of the study Doppler ultrasound of the pelvic and abdominal veins! ? What is behind this study and what information can it reveal? Check it out before you go for this study yourself! 

There is often a misconception that testing Transvaginal ultrasound is able to replace expert Doppler ultrasound examination of the veins with their assessment through the sheaths. Transvaginal examination (TV ultrasound) performed by gynaecologists is only a screening examination, allowing the pelvic venous vessels to be assessed in a way that is quite significantly different from reality. This is due to the limitations and distortions of the imaged area, the way the examination is performed and the very design of the ultrasound probe used for transvaginal examination. It is important to remember that most venous problems originate in the epigastrium (the pelvic veins are usually the recipient of the problem, and this is due to gravitational influences), and any insufficiency should be confirmed by a standing examination. For this reason, it is crucial to perform a trans-shell Doppler ultrasound of the veins with a full assessment of the pelvic floor, the most common sites of venous leakage and, most importantly, a full assessment of the abdominal and pelvic veins. The Doppler ultrasound examination should also exclude other causes (so-called secondary causes), which often lead to flow disturbances or redistribution.

Magnetic resonance venography (MRV)

MR venography is a minimally invasive examination, usually performed with intravenous administration of gadolinium (Gd) contrast agent, using a magnetic field and radio waves to create a comprehensive map of veins and organ structures. MR venography can assess contrast dynamics, demonstrate stasis or flow in the veins (assessed by analysing the movement of excited hydrogen atoms), and perfectly visualise thrombotic changes, both in the acute phase of thrombosis and retrograde changes in the so-called post-thrombotic syndrome.

MR venography study Among other things, it enables an accurate assessment of the anatomy of the venous system, allows the detection of various vascular malformations, perfectly illustrates the collateral circulation, allows the degree of venous dilatation to be assessed and, importantly, perfectly illustrates extrauterine and intrauterine endometrial lesions (adenomyosis) and adhesions, which are often formed after caesarean sections or laparoscopies performed in the abdominal or pelvic area. Further advantages are the high resolution of imaging and the absence of ionising radiation. The latter feature is crucial for women of reproductive age.

Among the undoubted disadvantages of venography performed using the MRI technique include its prolonged duration (it can even reach 1h), its rather high cost, its limited availability (venous MRI examinations should be performed on 3-tesla systems and assessed by experienced staff) and the usual contraindications to MR imaging and those arising from allergy to the gadolinium contrast agent.

Computed tomography venography (CTV)

Computed tomography venography (CTV) is an imaging study that uses X-rays to create images of organs and veins. The patient receives intravenous contrast, which increases the absorption of X-rays from the vessels being contrasted, thus allowing them to be better visualised. CT venography with intravenously administered iodine contrast allows: a detailed evaluation of the vascular anatomy, including the possibility of performing 3D reconstruction and curved vessel analysis, detection of anatomical anomalies, visualisation of possible causes of external compression, and an excellent assessment of organ pathology. The undoubted advantages of CT venography are the short examination time (the entire examination takes up to 3 minutes) and the very good spatial resolution of the imaged structures. The disadvantages are certainly the exposure to ionising radiation, the need to administer iodine contrast (allergies to it occur) and the low sensitivity in detecting endometrial lesions.

Treatment strategy for pelvic venous insufficiency

Our phlebotomists use proprietary methods to treat veins in the abdomen and pelvis (mainly minimally invasive). They perform such types of treatments as:

• venous embolisation - A procedure involving intravenous closure of malfunctioning veins;
• venoplasty - Modelling and dilatation of pathologically or developmentally narrowed venous vessels;
• venous stenting – inserting special mini-scaffolds into the lumen of a narrowed (or nearly obstructed) venous vessel, which permanently dilate it.

These treatments have significant therapeutic benefits:

• restore normal blood flow in the venous vessels, improving outflow from the lower limbs and reducing stasis;
• reduce the excessive load on the reservoir veins in the pelvis, both those in the pelvic walls and in the organs;
• reduce vascular volume overload in the leg venous system.

This novel treatment strategy significantly increases the effectiveness of venous disease treatment compared to the traditional approach focusing mainly on symptoms. Another advantage sequential causal treatment is the possibility of avoiding certain venous interventions in the legs. With more than 10-year follow-up by doctors at the Phlebology Clinic it follows that in some female patients after. pelvic venous embolization and treating the limb venous leaks descending from the pelvis to the legs, there is a spontaneous regression of symptoms and a reduction of venous reflux in the main limb axes. This allows, for example, for the preservation of the great saphenous vein, which in the opposite situation (treatment not following hemodynamic principles) would have been unnecessarily and irreversibly closed.

Treatment methods

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Doctors performing these procedures

dr n. med. Cezary Szary - phlebologist, radiologist

radiology and diagnostic imaging, phlebology

dr n. med. Jerzy Leszczyński - vascular surgeon

chirurgia ogólna, chirurgia naczyniowa

dr n. med. Justyna Wilczko – flebolog, internista

Phlebology, internal medicine, radiology and diagnostic imaging

Dr Krzysztof Celejewski - phlebologist, surgeon

general surgery, phlebology

dr n. med. Małgorzata Łodyga – flebolog, kardiolog

cardiology, phlebology, Doppler ultrasonography

dr n. med. Marcin Napierała – flebolog, chirurg ogólny, chirurg onkolog

general surgery, phlebology

dr hab. n. med. Michał Zawadzki – radiolog interwencyjny

radiology and diagnostic imaging, interventional radiology

prof. dr hab. n. med. Tomasz Grzela – flebolog, chirurg

General surgery, phlebology

Mostly
questions asked

• Can untreated pelvic venous insufficiency lead to serious complications?

  Untreated pelvic venous insufficiency can have a number of different effects. It can lead to:

  • increasing psychological distress (depression or anxiety) as a result of chronic pain;

  • chronic, worsening pain in the back, lower abdomen or perineum;

  • development of varicose veins of the lower limbs and intimate areas;

  • deep vein thrombosis;

  • a significant deterioration in patients' quality of life;

  • problems in intimate life

• Are pelvic venous insufficiency and varicose veins of the intimate area common social pathologies?

  From our daily practice, pelvic venous insufficiency and associated vulvar and perineal varicose veins are a common condition that is mainly diagnosed with in women who have previously given birth, usually after the second or third birth. This problem is encountered much more frequently after multiple pregnancies, including in women undergoing prolonged hormonal stimulation, e.g. at conception in vitro. 

  The typical age range for ladies presenting to the Phlebology Clinic with suspected pelvic venous insufficiency is increasingly changing. It currently stands at: 18-50 years. This is due to the fact that more and more gynaecologists have started to recognise the problem, more and more urogynaecological physiotherapists have started to recognise the problem, as well as the level of knowledge on the subject has greatly increased among patients.

  During the so-called reproductive period, the symptoms of venous stasis in the pelvis and the cosmetic defect resulting from the presence of varicose veins of the intimate area are most pronounced. According to a study on large groups of women, approximately 20% women of reproductive age experience chronic pelvic pain, with pelvic venous insufficiency being the cause in approximately 30-40% of them. Varicose veins of the intimate area occur in approximately 10-15% women of reproductive age. These numbers increase significantly in multiparous women.

  Our own experience shows that in more than 70% women giving birth suffering from venous insufficiency of the lower limbs, the problem initially starts in the venous system of the small pelvis and abdominal cavity. This regularity has even higher correlation rates in Patients who come to the Phlebology Clinic for an appointment with a venous problem already before their first pregnancy or after their first or second miscarriage pregnancy. These are patients who present with significant anatomical variations leading to impaired outflow in the venous system, secondary pelvic venous congestion and increased pressure in the venous system in the lower limbs.

• Is vulvodynia in any way related to pelvic venous insufficiency and varicose veins of the intimate area?

  Vulvodynia is a fairly common disorder in women, involving constant discomfort, burning or pain that is localised to the intimate area, typically the vaginal vestibule, vulva or perineum. There are various forms of this affliction. Vulvodynia proper is characterised by chronic complaints of a fairly constant nature. The painful symptoms can vary in intensity and can occur in the labia majora, labia minora and also project to the vestibular area. Induced vulvodynia, otherwise known as provoked, is usually confined to the vaginal vestibule. It is an intense and burning pain typically triggered when touching or applying pressure to the vulvar area. Activities that trigger it are usually sexual intercourse and transvaginal gynaecological examination.

  Pelvic venous insufficiency combined with congestion of the vaginal wall and not infrequently with varicose veins of the intimate area is one reason for this type of condition. Our observations show that this type of "venous" vulvodynia this is quite common in young patients with venous compression syndromessuch as nutcracker syndrome or May-Thurner syndrome.

• Why does pelvic venous insufficiency more often affect women after pregnancies?

  This is due to the fact that significant changes occur in the venous system during pregnancy. Among other things, this occurs:

  • increased body weight, which puts additional strain on the venous system These changes can lead to permanent weakening of the vessel walls and impaired blood flow;

  • increase in circulating blood volume by 30-50%;

  • hormone-dependent relaxation and dilatation of venous vessel walls;

  • a significant increase in the volume of the uterus, which over time puts pressure on the mother's venous vessels.

• How to distinguish pelvic venous insufficiency pain from other gynaecological complaints?

  Characteristics of pain resulting from pelvic venous insufficiency include:

  • its intensity at the end of the day and after standing for a long time;
  • reduction of discomfort after resting in a lying position;
  • co-occurring with a feeling of heaviness in the legs and varicose veins on the legs;
  • an increase in discomfort just before or during menstruation (first 2 days);
  • co-occurrence with abdominal bloating.

• Who treats pelvic venous insufficiency?

  At Phlebology Clinic Diagnosis and treatment of pelvic venous insufficiency are provided by a team of specialists from the fields of: phlebology, diagnostic imaging and interventional radiology. In more difficult cases, we also collaborate with gynaecologists and vascular surgeons more familiar with the issue.

  The therapeutic approach is determined by the cause of the disease. The biggest mistake in treating pelvic venous insufficiency and venous insufficiency of the lower limbs secondary to it is treating the Patient without a thorough imaging diagnosis and without excluding other concomitant diseases such as endometriosis or adenomyosis. In our practice, we quite often encounter cases where the Patient has undergone embolisation or surgical treatment without a properly performed qualification, only on the basis of the radiological description.

  In the most difficult cases, when symptomatic pelvic venous insufficiency are accompanied by varicose veins of the intimate area and legs (full-blown form of the disease), we take a holistic approach. It involves eliminating the cause of venous stasis in the small pelvis (using venous embolisation, venous angioplasty, implantation of venous stents or use of chemical obliteration) and then treatment of varicose veins of the perineum, vulva and finally disfiguring venous widening in the legs (spider veins, dilated reticular veins and varicose veins).

  In the Department of Phlebology, minimally invasive procedures carried out via percutaneous access and further via the endovascular route are by far the most common. Each procedure is carried out under the control of an ultrasound probe and digital angiography equipment (a so-called 'angiogram' is created). venogram, or vein map).

  Procedure venous embolisation is carried out in a 4-6 hour admission to the hospital wardwithout the need for general anaesthesia. Treatments are carried out only in shallow sedation Under the guidance of the anaesthetic team. The patient is conscious and responds to the doctors' instructions given during the procedure. Recuperation from this type of procedure is usually quite short at 3-10 days.

Explore our latest publications and research papers.

The scientific activities of the team at the Department of Phlebology make a significant contribution to the development of modern phlebology. Our scientific research and publications confirm the effectiveness of innovative and proprietary treatment methods, setting new standards in the treatment of venous diseases.

1 /

Do patients with recurrent venous disease benefit more from sequential treatment than those without previous venous interventions?

The doctors of the Phlebology Clinic have pioneered the causal treatment of venous disease worldwide. Our proprietary treatment methods, validated by scientific research and prestigious publications, have opened up new possibilities for all phlebology patients.

2 /

Can the number of pregnancies be a predictor of venous disease progression and influence the effectiveness of treatment?

The introduction of a proprietary haemodynamic and radiological classification used in the assessment of ovarian venous insufficiency has facilitated treatment planning for patients with pelvic venous insufficiency. This proprietary method allows for a precise assessment of blood flow abnormalities, enabling clinicians to select the optimal therapeutic strategy.

3 /

Radiological-hemodynamic classification of ovarian venous insufficiency

A study by doctors in the Department of Phlebology shows that there is a full correlation between the treatment of pelvic venous insufficiency in women and the impact of this treatment on the long-term success of treatment of limbic venous disease.

4 /

Does the treatment of pelvic venous insufficiency really have no impact on lower limb venous disease?

Pelvic venous insufficiency - what should every woman know about its symptoms?

Przewlekłe, comiesięczne bóle podbrzusza, do tego bolesne miesiączki i uczucie pełności w kroczu? ? Czy to tylko zwykłe kobiece dolegliwości, czy może coś więcej? Zapoznaj się ze specyfiką objawów występujących u Pań z niewydolnością żylną miednicy – schorzenia, o którym mówi się zdecydowanie za mało! ?

Dr Venus: virtual patient advisor

Looking for answers to your vein question? Ask our Dr Venus!

Ask Dr Venus a question

• 
  Can you help me with the problem of painful periods? My gynaecologist suspects a venous problem in me.
• 
  Painful periods can be associated with a variety of problems, including pelvic venous insufficiency. If venous problems are suspected, consultation with a phlebology specialist is recommended.

01 /

Vascular spider veins

Pajączki naczyniowe to drobne, czerwone lub sine rozszerzenia naczyń krwionośnych pod skórą, przypominające swoim wyglądem pajęczynę.

02 /

Varicose veins of the lower limbs

Varicose veins are permanent dilations of the superficial veins of the legs, visible through the skin, resulting from venous valve insufficiency.

03 /

Venous edema of the shin

Venous oedema of the shin is a visible enlargement of tissue volume in the lower leg area, caused by venous blood stasis and increased vascular permeability.

04 /

Pelvic venous insufficiency

Pelvic venous insufficiency manifests as chronic pelvic pain and discomfort, resulting from stagnation of venous blood in the venous plexuses of the reproductive organs.

05 /

Venous compression syndromes

Venous compression syndromes arise from obstruction of venous blood outflow through large vascular trunks in the pelvis and abdominal cavity.

06 /

Venous disease in pregnancy

Venous disease in pregnancy develops under the influence of hormonal and mechanical changes associated with the developing pregnancy, leading to venous stasis and varicose vein formation.

07 /

Varicose veins of the spermatic cord

Vestibular varices are the most common symptom of a condition called male pelvic venous insufficiency.

08 /

Venous thrombosis

Venous thrombosis is a serious condition of the venous system in which a thrombus (clot) forms inside an altered venous vessel.

01 / 08

Causal vein treatment

The phlebologists at the Department of Phlebology have pioneered the causal treatment of venous disease.

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