Vulvar varicosities: New procedure, durable results Karim Abd El Tawab

Comment & Analysis

In the past two decades, there has been a shift in varicose vein management from conventional surgical treatments to outpatient interventional procedures. Depending on the type and site of the affected vein, patients now have many other treatment options— namely with ablation, glue, coil embolization and sclerotherapy. These minimally invasive options offer better disease control with maximal safety, less pain and less recurrence.

With increasing patient awareness, one of the common clinical scenarios interventionalists encounter now is female patients with pelvic varicosities associated with the presence of vulvar, perineal, inguinal, or gluteal varicose veins, sometimes also associated with lower-extremity varicosities.

The prevalence of vulvoperineal varices in the general population is still unknown. Yet, in a series of over 4,000 female vein clinic patients, as written about by J T Hobbs et al in a 1990 British Journal of Hospital Medicine paper, the incidence of vulvar varices was about 4%, rising to 40% in patients with pelvic venous insufficiency. These latter patients are typically multiparous women between 20 and 40 years of age suffering from coital aches, genital heaviness, discomfort, continuous arousal, as well as lower urinary symptoms in severe cases.

Despite it being a common problem, there are few publications discussing