Other Vein Conditions
A number of those who develop deep vein thrombosis (DVT) in the legs will develop a condition called post-thrombotic syndrome. The symptoms include chronic swelling, pain, tenderness, and, often, brown discoloration of the skin at the ankle or lower calf.
Post-thrombotic syndrome and venous stasis ulceration may be prevented by early diagnosis and prompt treatment of DVT.
The routine daily use of prescription grade compression stockings as soon as a diagnosis of DVT has been shown to be preventative of complications. At MD Vein& Skin Specialists we help local physicians with quick diagnosis of DVT by providing ultrasound examination expertise available at short notice.
Some chronic swelling of the extremities may be due to lymphedema, an obstruction of microscopic channels which pump and carry a clear tissue fluid from the extremities back to the bloodstream. Lymphedema often presents as swelling at the toes or on the top of the foot but it may also involve the entire extremity.
Some patients are born with swelling in the extremities due to lymphedema and others develop lymphedema later in life. Abnormalities of the lymphatic channels present at birth result in congenital lymphedema; others will develop lymphedema due to obstruction from recurring cellulitis or soft tissue infections, surgical procedures, or compression by abdominal obesity or tumor growth. Morbidly obese patients with venous insufficiency usually have a component of lymphedema as well.
Mild lymphedema may be treated with elastic compression hose and periodic elevation of the legs higher than the heart. Evaluation and treatment of any underlying disorders is important as well. Severe lymphedema may require manual lymphatic drainage (MLD) therapy, a series of physical therapy treatments involving massage and compression wraps to reduce the degree of limb swelling.
Some patients may benefit from daily use of compression pumps and sleeves on the involved limb to help pump the lymph fluid out of the limb. Untreated lymphedema usually will get worse and may even cause other complications.
Lymphedema and any other type of leg swelling greatly increase the risk of infection in the skin and fatty tissues (cellulitis).
Labial Varicose Veins
Some women develop varicose veins near the labia. Usually, these varicose veins become prominent during pregnancy and improve after the baby is born. Like leg varicose veins, labial varicosities often worsen with each pregnancy. They can be painful.
Evaluation of labial varicose veins study of the veins of the abdomen, pelvis, genitalia, and legs. Treatment depends on the source of the blood flow refluxing into the labial veins. Many patients can be treated very effectively with foam sclerotherapy injections by ultrasound or fluoroscopic (X-ray) guidance to seal shut the abnormal deep pelvic and labial veins. Some patients with more extensive refluxing pelvic veins or with refluxing ovarian veins benefit from treatments which seal shut the larger abnormal veins to prevent reflux into the deep pelvic veins.
Pelvic Congestion Syndrome
High pressure in deep pelvic veins can cause pelvic pain, tenderness, or pain with intercourse. The pain can be either a dull, aching pain or a sharp, deep pain. This pain often is worse just before menstrual period, with prolonged standing, or with intercourse. Once other pelvic organ pathology such as cysts or abnormal growth of the uterus or ovaries or infection have been ruled out, the syndrome is called Pelvic Congestion Syndrome. Some patients with Pelvic Congestion Syndrome have an underlying correctable problem.
A similar process in the male causes reflux of blood down a testicular vein into the scrotum. The high venous pressures in the scrotum result in progressive development of varicose veins in the scrotum and the spermatic cord which connects the testicle to the rest of the body. These scrotal varicose veins are called a varicocele. Some varicoceles cause pain, especially with lifting; others reduce the sperm count and may be responsible for male infertility. Treatment of the varicocele by sealing the testicular vein usually resolves the pain or infertility problem.