Varicose veins

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Written by Zhang Xue Min
Vascular Surgery
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Does Grade II varicose veins require surgery?

In our clinical staging, Grade 2 varicose veins are the most common type of varicose veins. Often, these do not have complications and are relatively early-stage. The decision to undergo surgery depends on the patient's personal treatment preference. Some individuals might be motivated by cosmetic reasons, such as wanting to wear skirts or shorts in the summer to show off their legs. In such cases, their desire for treatment might be stronger. For some older individuals, they might not care as much, so the choice of undergoing surgery or opting for conservative treatment for Grade 2 varicose veins really depends on the patient's own wishes.

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Written by Wang Cheng Lin
Orthopedics
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Is leg cramp related to varicose veins?

Leg cramps are not directly related to varicose veins. The most common cause of leg cramps in clinical practice is calcium deficiency, which can lead to cramps in the calves at night. For such cases, the first step is to supplement calcium by consuming foods high in calcium, such as drinking more milk and eating more legumes. Varicose veins are caused by the tortuosity of the veins in the lower leg, and patients with varicose veins often have some degree of deformation in the venous valves, which leads to varicose veins. This condition has no relation to calf cramps, as the causes and conditions of the diseases are completely different.

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Written by Wang Shuai
Urology
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What are the symptoms of varicocele?

If the patient has mild varicocele, they often have no symptoms and it is not easily detected; in such cases, no special treatment is needed. However, with moderate or severe varicocele, the patient may experience a dragging pain in the testicles, especially after intense physical activity, prolonged sitting, or standing, which makes the pain more pronounced. During a physical examination, twisted, worm-like clusters of veins can be felt within the scrotum. Patients with varicocele should undergo further routine semen analysis to assess if the semen quality is affected. If sperm quality is impacted, it could lead to a decline in male fertility, and surgical treatment should be considered when necessary.

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Written by Zhang Xue Min
Vascular Surgery
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Can you run if you have varicose veins in your lower legs?

Patients with simple varicose veins can run. The movement of muscles, especially during running when the calf muscles are active, can compress the deep veins, facilitating the emptying of these veins. This benefits the flow of blood in the superficial veins through the communicating veins back to the deep venous system, thus participating in the systemic circulation. Therefore, patients with varicose veins in the calves can still run in the majority of cases. However, there are exceptions. If a person experiences significant muscle pain, it is important to be cautious as there may be a thrombus in the muscle veins. If there is a thrombus in the muscle veins, and the return flow in the deep veins is obstructed, this may also cause varicose veins. In cases of fresh thrombosis, running might lead to the detachment of the thrombus. Thus, patients in such conditions are advised not to run until further evaluation is confirmed by an ultrasound examination.

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Written by Zhang Xue Min
Vascular Surgery
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Can venous varicosity be measured by CT?

Venous varicosities can undergo CT imaging, but generally, it's best to avoid injecting medication into the varicose veins. If the varicosities are in the lower limbs, a routine ultrasound examination is usually sufficient. To perform venous imaging with CT, medication is typically administered through the upper limbs. It moves through the general circulation, enters the arteries, reaches the peripheral tissues, and then flows back through the veins to allow imaging of the lower limb veins. This process is time-consuming, laborious, and costly; therefore, CT is generally not used to detect lower limb venous varicosities. However, CT can be used to examine venous abnormalities in other areas, such as problems with abdominal veins.

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Written by Zhang Xue Min
Vascular Surgery
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What does it mean when varicose veins occasionally have blocked blood flow?

The so-called varicose veins are caused by blood circulation blockages, which likely refers to local thrombus formation, leading to feelings of congestion in lower limbs, or caused by compression from above, such as tight clothing, exacerbating the obstruction of blood flow. This might result in increased surface tension of varicose veins in the lower extremities. Additionally, there might be some pain upon pressing, or even spontaneous pain. In such cases, differentiated treatment is required. For instance, if the issue is due to compressive clothing, like tight-knee socks or pants legs that are too tight, simply relieving the pressure should suffice. However, if a thrombus has formed causing increased local tension, pressing or massaging must be strictly avoided, as there is a risk the thrombus might dislodge and potentially lead to pulmonary embolism.

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Written by Zhang Xue Min
Vascular Surgery
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How should young people deal with varicose veins in the lower legs?

Firstly, for young people with varicose veins in the lower leg, it is recommended to go to the hospital for an ultrasound examination to check the condition of the deep veins. Additionally, consult a professional vascular surgeon to assess the severity. If the deep veins are unobstructed and the superficial varicose veins in the lower leg are not too severe, the doctor will suggest the patient wear medical compression stockings and continue with normal life activities. If the condition is more serious or there are certain issues with the deep veins, the doctor might recommend surgery. For such patients, it is important in daily life to avoid standing or sitting for long periods, and to avoid letting the legs dangle for too long. If standing, one can also step in place appropriately, which helps alleviate varicose veins. Also, when resting, take any opportunity to elevate the legs and avoid soaking feet in hot water.

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Written by Zhang Xue Min
Vascular Surgery
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Can varicose veins be detected by ultrasound B?

Ultrasound is currently the main examination method for varicose veins. It is non-invasive, safe, and affordable, making it one of the standard methods for assessing varicose veins. Besides viewing the superficial veins, it also allows visualization of the deformed deep veins within the muscles, enabling a basic assessment of the causes of varicose veins. Ultrasound now plays a crucial role in the treatment of varicose veins. Many new treatment methods, such as blood flow modulation techniques like wrist flexing, require high precision in ultrasound use. It is essential to locate the reflux points using ultrasound, and then specifically target these points for ligation.

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Written by Chen Feng
Urology
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How is varicocele treated?

The treatment of varicocele depends on the severity of the condition. Clinically, some varicocele patients do not exhibit obvious symptoms, or show no symptoms at all and are only diagnosed during physical examinations. These patients can generally be treated conservatively by avoiding standing for long periods, avoiding prolonged walking, and by wearing tight underwear to alleviate symptoms of varicocele. However, some patients with varicocele do exhibit clear symptoms, including discomfort and pain in the scrotum on the affected side, especially after long periods of walking. These symptoms can become more severe and may also be accompanied by abnormalities in semen quality. These patients generally require surgical intervention, such as high ligation of the veins.

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Written by Chen Feng
Urology
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What should I do about varicocele?

The treatment methods for varicocele vary based on the severity of the condition. Clinically, some patients with varicocele show no obvious symptoms and it is only discovered during a physical examination. These patients can generally be observed temporarily, and can also wear tight underwear or use a scrotal support to alleviate the condition. However, some patients do exhibit clear symptoms, such as a significant sensation of heaviness in the scrotum, especially after standing or walking for long periods, where the pain becomes more pronounced. These patients generally need to consider surgical treatment, where the main procedure involves high ligation of the spermatic vein. This can help alleviate symptoms and also improve the quality of semen.