Varicose veins are swollen and twisted veins, most commonly affecting the legs, that can cause discomfort or pain. A range of surgical and non-surgical treatments are available, depending on the severity of the symptoms and a person's circumstances and preferences. Varicose veins are more common in women than in men and tend to run in families. They usually develop between the ages of 30 and 60 years and tend to worsen with age. Show Veins are the blood vessels that carry blood from the body to the heart (whereas arteries carry blood from the heart to the body). Veins that lie just beneath the skin surface are referred to as “superficial veins” while the veins found deep inside the muscles are referred to as “deep veins”. Other veins, called "communicating veins", connect the superficial and deep veins, allowing blood to flow between them. Properly functioning veins have a series of one-way valves that keep the blood flowing in one direction towards the heart. Varicose veins occur when the valves within the veins stop working properly and allow blood to backflow. The blood pools in the area below the affected valve causing the vein to enlarge and stretch. Varicose veins appear under the skin as bluish-green lines, which may bulge out or appear twisted and contorted. The superficial veins in the legs are the most common place for varicose veins to occur – due mainly to problems with vein junctions (where different veins join together) in the upper thigh, behind the knee, and in the calf muscle. However, they can occur in other areas of the body (such as haemorrhoids, which are varicose veins in the anus or rectal area). A number of factors contribute to the development of varicose veins. These include:
Lifestyle factors also play an important role and people who have jobs that involve standing for prolonged periods of time, eg: nurses, flight attendants, and teachers, are at higher risk of developing varicose veins. Common symptoms include:
Some women experience a worsening of symptoms during menstruation. Complications due to varicose veins may include:
DiagnosisVaricose veins are usually visible so it is possible to make a diagnosis simply from their appearance. A doctor will perform a physical examination to assess the extent of the varicose veins. They may also order an ultrasound test called a doppler which enables the blood flow and structure of the veins to be seen on a monitor. It can also show if any blood clots are present. A duplex ultrasound may also be performed. This is a more advanced scan and displays the image in colour. Another test, known as air plethysmography (APG), may be used to better identify how well affected veins are working by measuring blood flows through the veins and arteries in the leg. TreatmentTreatment may not be medically necessary unless symptoms are causing problems. However, some people may want treatment for cosmetic reasons, because they are unhappy with the appearance of varicose veins. If varicose veins are small and not too uncomfortable, elastic compression stockings may be recommended. These are worn during daily activities and help to compress the veins, keeping them from stretching and limiting any discomfort or pain. For more problematic cases a range of procedures – surgical and non-surgical – are available to seal or remove varicose veins. A combination of treatment techniques may sometimes be used. Treatment options for varicose veins have changed significantly in the past 25 years and continue to evolve, especially the development of less invasive procedures that don’t require having to stay in hospital. NON-SURGICAL TREATMENT: Sclerotherapy Endovenous thermal ablation A small incision is made at one end of the affected vein and a catheter (tube) is inserted, guided by an ultrasound scanner. Once in place, heat generated by a laser or radiofrequency emitter is used to seal or destroy the vein.SURGICAL TREATMENT: If the vein junction where the varicose vein originates has been shown by an ultrasound scan not to be working properly, then the most common surgical treatment is to tie off the varicose vein at this junction (most commonly the upper thigh, behind the knee, or in the calf muscle). Surgery involves making a small incision in the leg, locating the vein junction, and tying off the varicosed vein. The vein is left in place but blood is prevented from flowing into it. Another surgical technique for treating superficial varicose veins is “vein stripping”, which is where the affected vein is completely removed. A small incision is made in the skin at either end of the affected vein and the junction where the affected varicose vein joins a larger vein is tied off. A flexible wire is then inserted into the varicose vein and withdrawn – removing the vein in the process. Both types of surgery can be performed under general or spinal anaesthetic and a stay in hospital may be required. This will be determined by the surgeon performing the surgery. A range of alterative surgical techniques may also be used under different circumstances. Things you can do to help prevent varicose veins include:
ReferencesFernando, R.S., Muthu, C. Adoption of endovenous laser treatment as the primary treatment modality for varicose veins: the Auckland City Hospital experience. N Z Med J. 2014;127(1399):43-50. Mayo Clinic (2019). Varicose veins (Web Page). Rochester, NY: Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643 [Accessed: 04/10/19]. NHS (2017). Varicose veins (Web Page). Redditch: National Health Service (NHS) England. https://www.nhs.uk/conditions/varicose-veins/ [Accessed: 04/10/19]O’Toole, M.T. (Ed.) (2017). Varicose vein. Mosby’s Dictionary of Medicine, Nursing & Health Professions (10th ed.). St Louis, MI: Elsevier. Weiss, R. (2018). Varicose veins and spider veins (Web Page). Medscape Drugs and Diseases. New York, NY: WebMD LLC. http://emedicine.medscape.com/article/1085530-overview [Accessed: 04/10/19]. Last Reviewed – October 2019 Mild cases do not need any treatment and will resolve of their own accord. Don’t feel overwhelmed, though, because successful treatment is possible. The veterinarian will clean the vaginal area and use antibiotic cream to lubricate the area, preventing drying. If your goal is not dog breeding, then the veterinarian may recommend spaying to eliminate the risk of future problems. If you are going to breed your dog, then artificial insemination would be the ideal choice. If the condition is severe, the veterinarian might consider suturing to get the mass returned to the vagina, after which it would subside once the heat cycle has been completed. The veterinarian will also make a decision whether to surgically take out the dead tissue. Doing so will avoid a reoccurrence of hyperplasia. Hormone therapy is also an option if your dog has not had any damage to the vaginal tissue and once urination is possible. Hormone therapy will accelerate the heat cycle and correct the vaginal prolapse. The veterinarian may apply topical cream to the area to reduce the swelling. Use a buster collar to prevent any licking. Top Page 2Mild cases do not need any treatment and will resolve of their own accord. Don’t feel overwhelmed, though, because successful treatment is possible. The veterinarian will clean the vaginal area and use antibiotic cream to lubricate the area, preventing drying. If your goal is not dog breeding, then the veterinarian may recommend spaying to eliminate the risk of future problems. If you are going to breed your dog, then artificial insemination would be the ideal choice. If the condition is severe, the veterinarian might consider suturing to get the mass returned to the vagina, after which it would subside once the heat cycle has been completed. The veterinarian will also make a decision whether to surgically take out the dead tissue. Doing so will avoid a reoccurrence of hyperplasia. Hormone therapy is also an option if your dog has not had any damage to the vaginal tissue and once urination is possible. Hormone therapy will accelerate the heat cycle and correct the vaginal prolapse. The veterinarian may apply topical cream to the area to reduce the swelling. Use a buster collar to prevent any licking. Top Page 3Mild cases do not need any treatment and will resolve of their own accord. Don’t feel overwhelmed, though, because successful treatment is possible. The veterinarian will clean the vaginal area and use antibiotic cream to lubricate the area, preventing drying. If your goal is not dog breeding, then the veterinarian may recommend spaying to eliminate the risk of future problems. If you are going to breed your dog, then artificial insemination would be the ideal choice. If the condition is severe, the veterinarian might consider suturing to get the mass returned to the vagina, after which it would subside once the heat cycle has been completed. The veterinarian will also make a decision whether to surgically take out the dead tissue. Doing so will avoid a reoccurrence of hyperplasia. Hormone therapy is also an option if your dog has not had any damage to the vaginal tissue and once urination is possible. Hormone therapy will accelerate the heat cycle and correct the vaginal prolapse. The veterinarian may apply topical cream to the area to reduce the swelling. Use a buster collar to prevent any licking. Top Page 4Mild cases do not need any treatment and will resolve of their own accord. Don’t feel overwhelmed, though, because successful treatment is possible. The veterinarian will clean the vaginal area and use antibiotic cream to lubricate the area, preventing drying. If your goal is not dog breeding, then the veterinarian may recommend spaying to eliminate the risk of future problems. If you are going to breed your dog, then artificial insemination would be the ideal choice. If the condition is severe, the veterinarian might consider suturing to get the mass returned to the vagina, after which it would subside once the heat cycle has been completed. The veterinarian will also make a decision whether to surgically take out the dead tissue. Doing so will avoid a reoccurrence of hyperplasia. Hormone therapy is also an option if your dog has not had any damage to the vaginal tissue and once urination is possible. Hormone therapy will accelerate the heat cycle and correct the vaginal prolapse. The veterinarian may apply topical cream to the area to reduce the swelling. Use a buster collar to prevent any licking. Top Page 5Mild cases do not need any treatment and will resolve of their own accord. Don’t feel overwhelmed, though, because successful treatment is possible. The veterinarian will clean the vaginal area and use antibiotic cream to lubricate the area, preventing drying. If your goal is not dog breeding, then the veterinarian may recommend spaying to eliminate the risk of future problems. If you are going to breed your dog, then artificial insemination would be the ideal choice. If the condition is severe, the veterinarian might consider suturing to get the mass returned to the vagina, after which it would subside once the heat cycle has been completed. The veterinarian will also make a decision whether to surgically take out the dead tissue. Doing so will avoid a reoccurrence of hyperplasia. Hormone therapy is also an option if your dog has not had any damage to the vaginal tissue and once urination is possible. Hormone therapy will accelerate the heat cycle and correct the vaginal prolapse. The veterinarian may apply topical cream to the area to reduce the swelling. Use a buster collar to prevent any licking. Top Page 6Mild cases do not need any treatment and will resolve of their own accord. Don’t feel overwhelmed, though, because successful treatment is possible. The veterinarian will clean the vaginal area and use antibiotic cream to lubricate the area, preventing drying. If your goal is not dog breeding, then the veterinarian may recommend spaying to eliminate the risk of future problems. If you are going to breed your dog, then artificial insemination would be the ideal choice. If the condition is severe, the veterinarian might consider suturing to get the mass returned to the vagina, after which it would subside once the heat cycle has been completed. The veterinarian will also make a decision whether to surgically take out the dead tissue. Doing so will avoid a reoccurrence of hyperplasia. Hormone therapy is also an option if your dog has not had any damage to the vaginal tissue and once urination is possible. Hormone therapy will accelerate the heat cycle and correct the vaginal prolapse. The veterinarian may apply topical cream to the area to reduce the swelling. Use a buster collar to prevent any licking. Top |