Embolization is not essential in the treatment of leg varices due to pelvic venous insufficiency.
OBJECTIVE
To consider if it is essential to perform embolization in the treatment of leg varices due to pelvic venous insufficiency.


METHODS
Review of the current literature concerning treatment options of leg varicose veins of pelvic origin.


RESULTS
Pelvic venous insufficiency, vulvar and pudendal varicose veins as well as pelvic congestive syndrome are under diagnosed entities. Embolization of ovarian and pelvic veins is well established in patients with pelvic congestive syndrome. In varicose veins of pelvic origin but without pelvic congestive syndrome, comparative studies comparing the outcome of embolization or treatment of varicose veins by sclerotherapy or phlebectomy alone are missing. Foam sclerotherapy or phlebectomy shows good results in patients with varicose veins of pelvic origin.


CONCLUSIONS
Embolization is not essential in the treatment of leg varices of pelvic origin without pelvic congestive syndrome. Foam sclerotherapy or phlebectomy shows good results in patients with vulvar or pudendal varicose veins. Randomized comparative studies using embolization of incompetent pelvic veins or sclerotherapy of varicose veins with pelvic origin should be performed.
Department of Dermatology, University of Bonn, Bonn, Germany eberhard.rabe@ukb.uni-bonn.de.
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Rabe
Department of Dermatology, University of Cologne, Cologne and Private Practice Bonn, Bonn, Germany.
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Pannier
D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000473:pathology; D010388:Pelvis / Q000098:blood supply* / Q000473:pathology; D014648:Varicose Veins / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D014689:Venous Insufficiency / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*
Pudendal varicose veins; pelvic congestive syndrome; pelvic venous insufficiency; sclerotherapy; vulvar varicose veins