Direct Fluoroscopic-Guided Sclerotherapy for Vulvoperineal Varices: An Experience in 70 Patients

Abstract

Purpose The aim of this study was to assess the safety and effectiveness of percutaneous vulvoperineal varices sclerotherapy using 2% polidocanol foam under fluoroscopic guidance. Subjects and Methods This is a retrospective review of prospectively collected data of 70 patients treated between June 2020 and November 2021, with a mean age of 31 years (range: 24–42 years). All patients were not pregnant with residual vulvoperineal varices after embolization of their refluxing tributaries of the ovarian vein and/or internal iliac veins presenting with vulvoperineal heaviness/pain with or without lower limb varicosities. Technical and clinical successes together with procedural complications were assessed. Results The technical success rate was 100%. No minor or major complications have been reported. Follow-up was at 1 week, 2 weeks, 6 months, and 12 months post sclerotherapy. Clinical success was observed in all patients with improvement in their symptoms. Conclusion Direct fluoroscopic-guided sclerotherapy for vulvoperineal varices offers a safe and effective treatment option with the ability of visualization and embolization of the pelvic leak points to avoid recurrence.

Interventional Treatment of Labial Varices

“…3 A 2022 review of 70 cases of fluoroscopically guided sclerotherapy for vulvoperineal varices by Abd El Tawab et al had a technical success rate of 100% with clinical improvement in all patients' symptoms. 26 If the appropriate patient is selected, direct sclerotherapy is an excellent and effective minimally invasive technique to reduce vulvar varices and associated symptoms, with minimal risk of complications. There has yet to be a randomized control trial formally assessing outcomes of treatment of uncomplicated vulvar varices with sclerotherapy.…”