ISSN 2398-2977      

Vagina: varicose veins

pequis

Synonym(s): Vaginal varicosities


Introduction

  • Cause: unknown.
  • Signs: vaginal varicose veins occasionally rupture/ulcerate, causing mild to moderate bleeding from the vulva, especially during pregnancy and estrus.
  • Diagnosis: clinical examination, examination with speculum.
  • Treatment: ligation of the varicose veins if required.
  • Prognosis: good.

Pathogenesis

Etiology

  • Unclear.
  • Possible suggested etiologies include:
    • Age-associated weakening of vein walls.
    • Increased blood flow to the genitalia under the influence of estrogen during esturs or pregnancy.
    • Impeded venous drainage during pregnancy due to abdominal distention Abdomen: distention.
    • Impeded venous drainage from the vestibular and vaginal components of the internal pudendal vein due to poor perineal conformation which has resulted in repeated stretching of the vestibular-vaginal tissues.
    • Vaginal dryness or irritation due to poor perineal/vulval conformation Vulva: conformation may result in vascular fragility and subsequent hemorrhage.

Predisposing factors

General

  • Age of mare (older).

Pathophysiology

  • Varicose veins (tortuous venous structures) develop in the vagina during estrus and pregnancy, particularly in older mares.
  • The varicose veins occur most commonly at the cranial aspect of the vestibular fold and on the dorsal vaginal wall.
  • Varicose veins may be up to 1-2 cm in diameter.
  • Varicose veins intermittently ulcerate/rupture, releasing blood which is seen at the vulval lips.

Timecourse

  • Intermittent and usually self-limiting bleeding from the vulva.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Fraser G S (2005) Differential diagnosis for vaginal haemorrhage in the mare. Equine Vet Educ 17 (3), 153-155 VetMedResource.
  • Madill S (2002) Reproductive considerations: mare and stallion. Vet Clin North Am Equine Pract 18 (3), 591-619 PubMed.
  • White R A S, Gerring E L, Jackson P G & Noakes D E (1984) Persistent vaginal haemorrhage in five mares caused by varicose veins of the vaginal wall. Vet Rec 115, 263-264 PubMed.

Other sources of information

  • Lofstedt R M (2011) Abnormalities of Pregnancy. In: Equine Reproduction. Eds: McKinnon A O, Squires E L, Vaala W E & Varner D D. pp 2451-2452. Wiley Blackwell.

Organisation(s)

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