title: Vulvar Varicosities: A Review.
abstract: BACKGROUND
  Vulvar varicosities (VV) are dilated and tortuous veins occurring within the external female genitalia. Patients may seek treatment of these varices for both medical and cosmetic purposes. In some patients, VV may be associated with a chronic pelvic pain syndrome called pelvic congestion syndrome (PCS).
  
  
  OBJECTIVE
  To review the English language literature on VV in both pregnant and nonpregnant women.
  
  
  METHODS
  A literature search pertaining to vulvar varicosities and PCS was performed using PubMed and Google Scholar databases.
  
  
  RESULTS
  There is an overall paucity of literature discussing VV, particularly in nonpregnant women without PCS. Management options for VV include compression, sclerotherapy, embolization, and surgical ligation. Treatment can be dependent on the coexistence of pelvic or leg varicosities and may require referral to a vein specialist for advanced imaging techniques and procedures. Direct sclerotherapy to VV may not provide adequate treatment if pelvic or leg varices are also present.
  
  
  CONCLUSIONS
  In women with persistent VV, imaging studies should be obtained before treatment to evaluate the surrounding venous anatomy of the pelvis and leg, as the results often affect the treatment approach. Patients presenting with VV and chronic pelvic pain should be evaluated for PCS.
authors.affiliation: *Medical College of Georgia at Augusta University, Augusta, Georgia; †Division of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Kim
authors.forename: Laura A
authors.initials: LA
authors.lastname: Greyling
authors.forename: Loretta S
authors.initials: LS
authors.lastname: Davis
mesh_terms: D004621:Embolization, Therapeutic / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008026:Ligation / Q000379:methods; D012307:Risk Factors; D015911:Sclerotherapy / Q000379:methods; D016896:Treatment Outcome; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D014844:Vulva / Q000098:blood supply*