GynecologyGynecology2079-56962079-5831Consilium Medicum3349810.26442/20795696.2019.5.190661Research ArticleDiagnostic and prognostic potential of the use of ultrasound and three-dimensional endo-visualization in women with pelvic varicose veinsGusAleksandr ID. Sci. (Med.), Prof.a_gus@oparina4.ruStupinDmitrii ACand. Sci. (Med.)stupindima@rambler.ruSemendiaevAndrei AD. Sci. (Med.), Prof.-CherepanovaMariia ACand. Sci. (Med.)batontchik@yandex.ruAkudovichNatalia VCand. Sci. (Med.), Imeloman00@bk.ruKulakov National Medical Research Center for Obstetrics, Gynecology and PerinatologyIrkutsk State Medical UniversityPirogov City Clinical Hospital №115102019215596416042020Copyright © 2019, Consilium Medicum2019Aim. To study the diagnostic and prognostic potential of the complex use of ultrasound and 3D laparoscopy in women with pelvic varicose veins (PVV). Outcomes and methods. The study included 100 women who were divided into two groups: the main group (39 patients with various severity PVV) and the control group (61 women with no venous system disorders). All patients had a complete clinical examination with the selection of pairs that had the most significant factors for the disease prognosis: average age over 35 years, history of varicose veins, pain in the lower abdomen, dysmenorrhea and dyspareunia. Examination of the small pelvis venous system included duplex angioscanning and retrograde endoscopic functional test controlled by the three-dimensional image. Multivariate analysis (logistic regression) was used to identify normative phlebological parameters. Results. Predictors of early PVV are the following rations: Vmax in the cava-ovarian segment / Vmax in the right ovary portal ≥ 8.3 and Vmax in the reno-ovarian segment /Vmax in the left ovarian portal ≥ 8. The severity of PVV is determined by a progression of alterations in hemodynamic parameters in the main ovarian veins and a spreading venous congestion in the small pelvis plexuses. Conclusions. Criteria of small pelvis phlebohemodynamics make it possible to predict a development of PVV and a severity of the pathological process. Ovarian varicose veins are characteristic of early PVV and venous plethora of all pelvis venous plexuses is characteristic of late PVV.pelvis varicose veinsa development of pelvis varicose veinsa severity of pelvis varicose veinsphlebohemodynamics criteriaварикозное расширение вен малого тазаформирование варикозного расширения вен малого тазастепень тяжести варикозного расширения вен малого тазафлебогемодинамические критерии[Бенасэрафф Б., Голдстейн С., Гроцман И. Ультразвуковые исследования в гинекологии. М.: МЕДпресс-информ, 2016; с. 288.][Гус А.И., Хамошина М.Б., Черепанова М.А. и др. Диагностика и лечение варикозной болезни вен малого таза у женщин. Новоси-бирск: Наука, 2014; с. 136.][Гус А.И., Семендяев А.А., Ступин Д.А. и др. Профилактика рецидива варикозной болезни вен малого таза у женщин. Акушерство и гинекология. 2016; 10: 103-8.][Семендяев А.А., Ступин Д.А., Черепанова М.А. и др. Патент на изобретение №2646563. Способ определения функционального состояния венозной системы малого таза у женщин. Дата государственной регистрации в Государственном реестре изобретений РФ 05.03.2018.][Michaels J.A, Campbell W.B, Rigby K.A. A new pragmatic classification system for varicose veins. Phlebology 2001; 16 (1): 29-33.][Гус А.И., Бачурина С.М., Хамошина М.Б. и др. Алгоритм обследования женщин с синдромом тазовых болей при подозрении на варикозную болезнь вен малого таза. Сиб. мед. журн. 2011; 105 (6): 83-5.][Бачурина С.М., Гус А.И., Хамошина М.Б. и др. Тазовая боль, ассоциированная с бесплодием у женщин: Пути решения проблемы. Сиб. мед. журн. 2011; 105; 6: 252-5.][Сосудистая хирургия: Национальное руководство. Под ред. В.С.Савельева, А.И.Кириенко. М.: ГЭОТАР-Медиа, 2014; с. 405-28.][Darenskaya M., Semendyaev A.A., Stupin D.A. et al. Lipid peroxidation processes in women with primary varicose veins of the pelvic. Free Ra-dical Biol Med 2018; 128 (S1): S49.][Davies M.G, Lumsden A.B. Chronic venous insufficiency. Minneapolis: Minnesota Cardiotext 2011.][Ferrara N, Kerbel R.S. Angiogenesis as a therapeutic target. Nature 2005; 438 (7070): 967-74.][Moreau P.M. Neovascularization is not a major cause of varicose vein recurrence. Int J Angiol 2002; 11 (2): 99-101.][Колесникова Л.И., Колесников С.И., Даренская М.А. и др. Активность процессов ПОЛ у женщин с синдромом поликистозных яичников и бесплодием. Бюллетень экспериментальной биологии и медицины. 2016; 162 (9): 300-3.][Kolesnicova L.I., Kolesnicov S.I., Darenscaya M.A. et al. Activity of LPO processes in women with polycystic ovarian syndrome and inferti-lity. Bull Experement Biol Med 2017; 162 (3): 320-2.][Gloviezki P. The care of patiens with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011; 53 (5): 2S-48S]