Semin intervent Radiol 2023; 40(04): 384-388
DOI: 10.1055/s-0043-1771040
Review Article

Interventional Treatment of Labial Varices

Victoria Risner
1   Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
,
Yuko McColgan
2   Yuko McColgan, Brookline, Massachusetts
,
Gloria Salazar
1   Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina
› Author Affiliations

Abstract

Labial varices are commonly seen in women with varicose veins of the pelvis. Initial management is conservative management since labial varies typically resolve, particularly in pregnant patients following delivery. Varices can be seen also in association with pelvic varices in the pelvic venous disease spectrum. Sclerotherapy is often the management. This article reviews the presentation and treatment of patients with labial varices, with a focus on interventional radiologic management.



Publication History

Article published online:
10 August 2023

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  • References

  • 1 Fassiadis N. Treatment for pelvic congestion syndrome causing pelvic and vulvar varices. Int Angiol 2006; 25 (01) 1-3
  • 2 Antignani PL, Lazarashvili Z, Monedero JL. et al. Diagnosis and treatment of pelvic congestion syndrome: UIP consensus document. Int Angiol 2019; 38 (04) 265-283
  • 3 Gavrilov SG. Vulvar varicosities: diagnosis, treatment, and prevention. Int J Womens Health 2017; 9: 463-475
  • 4 Bell D, Kane PB, Liang S, Conway C, Tornos C. Vulvar varices: an uncommon entity in surgical pathology. Int J Gynecol Pathol 2007; 26 (01) 99-101
  • 5 Giannouli A, Tsinopoulou VR, Tsitsika A, Deligeoroglou E, Bacopoulou F. Vulvar varicosities in an adolescent girl with morbid obesity: a case report. Children (Basel) 2021; 8 (03) 202
  • 6 Khan TA, Rudolph KP, Huber TS, Fatima J. May-Thurner syndrome presenting as pelvic congestion syndrome and vulvar varicosities in a nonpregnant adolescent. J Vasc Surg Cases Innov Tech 2019; 5 (03) 252-254
  • 7 Kachlik D, Pechacek V, Musil V, Baca V. The venous system of the pelvis: new nomenclature. Phlebology 2010; 25 (04) 162-173
  • 8 Eklöf B, Rutherford RB, Bergan JJ. et al; American Venous Forum International Ad Hoc Committee for Revision of the CEAP Classification. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg 2004; 40 (06) 1248-1252
  • 9 Labropoulos N, Tassiopoulos AK, Gasparis AP, Phillips B, Pappas PJ. Veins along the course of the sciatic nerve. J Vasc Surg 2009; 49 (03) 690-696
  • 10 Ricci S, Georgiev M, Jawien A, Zamboni P. Sciatic nerve varices. Eur J Vasc Endovasc Surg 2005; 29 (01) 83-87
  • 11 Gavrilov SG, Moskalenko YP, Karalkin AV. Effectiveness and safety of micronized purified flavonoid fraction for the treatment of concomitant varicose veins of the pelvis and lower extremities. Curr Med Res Opin 2019; 35 (06) 1019-1026
  • 12 Kim AS, Greyling LA, Davis LS. Vulvar varicosities: a review. Dermatol Surg 2017; 43 (03) 351-356
  • 13 Choudur HN, Joshi R, Munk PL. Inferior gluteal vein varicosities: a rare cause of sciatica. J Clin Rheumatol 2009; 15 (08) 387-388
  • 14 Gavrilov SG, Vasilyev AV, Krasavin GV, Moskalenko YP, Mishakina NY. Endovascular interventions in the treatment of pelvic congestion syndrome caused by May-Thurner syndrome. J Vasc Surg Venous Lymphat Disord 2020; 8 (06) 1049-1057
  • 15 Francheschi C, Bahnini A. Treatment of lower extremity venous insufficiency due to pelvic leak points in women. Ann Vasc Surg 2005; 19 (02) 284-288
  • 16 Greiner M, Dadon M, Lemasle P, Cluzel P. How does the patho-physiology influence the treatment of pelvic congestion syndrome and is the result long-lasting?. Phlebology 2012; 27 (Suppl. 01) 58-64
  • 17 Marcelin C, Le Bras Y, Molina Andreo I, Jambon E, Grenier N. Diagnosis and management of pelvic venous disorders in females. Diagnostics (Basel) 2022; 12 (10) 2337
  • 18 Meissner MH, Khilnani NM, Labropoulos N. et al. The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: a report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders. J Vasc Surg Venous Lymphat Disord 2021; 9 (03) 568-584
  • 19 Lurie F, Passman M, Meisner M. et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord 2020; 8 (03) 342-352
  • 20 Scotti N, Pappas K, Lakhanpal S, Gunnarsson C, Pappas PJ. Incidence and distribution of lower extremity reflux in patients with pelvic venous insufficiency. Phlebology 2020; 35 (01) 10-17
  • 21 Maratto S, Khilnani NM, Winokur RS. Clinical presentation, patient assessment, anatomy, pathophysiology, and imaging of pelvic venous disease. Semin Intervent Radiol 2021; 38 (02) 233-238
  • 22 Hartung O. Embolization is essential in the treatment of leg varicosities due to pelvic venous insufficiency. Phlebology 2015; 30 (1, Suppl): 81-85
  • 23 Rabe E, Pannier F. Embolization is not essential in the treatment of leg varices due to pelvic venous insufficiency. Phlebology 2015; 30 (1, Suppl): 86-88
  • 24 Xu J, Wang YF, Chen AW, Wang T, Liu SH. A modified Tessari method for producing more foam. Springerplus 2016; 5: 129
  • 25 Tanaka ME, Kutsenko O, Salazar G. Choosing the most appropriate treatment option for pelvic venous disease: stenting versus embolization. Semin Intervent Radiol 2021; 38 (02) 182-188
  • 26 Abd El Tawab KA, Hagag MAA, Khafagy RTM. Direct fluoroscopic-guided sclerotherapy for vulvoperineal varices: an experience in 70 patients. Arab Journal of Interventional Radiology 2022; 6 (01) 25-32