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I have been to 2 vascular surgeons, but they only seem interested in taking care of the varicose vein in my leg that is causing pain to my ankle. My vulvar varicose vein is increasingly painful and swollen. What treatment choices are there? Can it be treated with endovenous laser ablation?
Laser treatment would probably not be appropriate for vulvar varicose veins. Sclerotherapy may be the better option. Obviously you would have to be examined before any treatment could be proposed.
Search for a phlebologist with some experience in treating vulvar veins. Laser is not an option. Foam sclerotherapy is my choice of treatment.
Most vulvar veins arise from a pelvic vein source in the lower abdomen, not the femoral vein. Therefore, endovenous laser ablation usually is not helpful. Ovarian veins in the lower abdomen often need to be treated with coil embolization. This can be done in a specialized center that has experience in these procedures.
The vulvar varicose vein is caused by venous insufficiency arising in the pelvic area. Since vascular surgeons consider themselves to be the penultimate authority on venous disease, they should have advised you that sclerotherapy works very well for the majority of vulvar varicosities. Rarely, if unsuccessful, pelvic ultrasound or contrast studies may be needed to identify the offending vein(s) for embolization treatment. Endovenous laser ablation can only be used on relatively straight veins because the fiber cannot bend too far, and insurance will only pay for the saphenous veins.
Usually sclerotherapy is used to treat those kinds of varicose veins. Find an interventional radiologist to do the procedures; they are specialists that do procedures with imaging.
Generally, vulvar veins have a source in the pelvis. This possibility needs to be investigated. If pelvic veins are the source, they should be treated. The vulvar vein itself is best treated directly by sclerotherapy.
Not sure. The affected area would need to be examined and an ultrasound would need to be performed.
Foam sclerotherapy is one way to treat vulvar varicose veins.
You cannot treat vulvar varices with endovenous laser ablation. These are varicose veins of the groin and genital area that are often made worse during pregnancy or menstruation. However, they can be addressed with sclerosing injections provided you are not pregnant or nursing. If you have saphenous incompetence of the long saphenous vein, we would recommend having this treated first. But if you are having pain from the vulvar varices, they can be treated first to alleviate symptoms.
Vulvar varicose veins are frequently treated with embolization and then the leg veins are treated, with endovenous laser ablation being a choice.
Vulvar varicose veins can be treated with foam sclerotherapy. Some patients might need more than one treatment, but the procedure is usually very successful. No, surgery is definitely not the first choice.
We do not do perform with lasers in our office. We use radiofrequency for heat source in treating veins. Laser is not a controlled heat source for treating veins. You need to have an ultrasound to determine where the vein problem starts. Treatment is different pending the ultrasound results. Your vein problem may start at the junction where all the veins come together and if that is the result of findings by ultrasound, your treatment will be different than what some clinicians may call "cosmetic," or they are not contracted with your insurance.
Groin, vulvar and labial varicose veins are easily treated with ultrasound-guided sclerotherapy. However, many vein care practitioners are not comfortable performing ultrasound-guided procedures because it takes special expertise. Find an interventional radiologist in your area who treats varicose veins.
Vulvar varicose veins usually originate in the pelvis and are rarely fed from insufficiency from below. They can be treated by either injection sclerotherapy or removing the vein through an incision. Some phlebologists suggest treating the pelvic venous insufficiency from above with embolization techniques. You need to reflect and ask yourself which veins bother you most day to day, the leg or the vulvar, and treat whichever one is the
answer. Certainly you should have a complete venous insufficiency study to investigate the source of the insufficiency and the severity.
Vulvar varicosities have been successfully treated with sclerotherapy. There usually is no need for endovenous laser ablation. Microphlebectomies, on the other hand, could be done but would be painful.
The vulvar varicosities are not really treated by endovenous laser ablation. Sometimes vulvar varicosities are caused or associated with pelvic venous insufficiency, so it's good to make sure that is not the issue. If it is not an issue, the vulvar varicosities can be nicely treated with sclerotherapy. Good luck.