Download PDF
Phlebologie 2013; 42(05): 270-277
DOI: 10.12687/phleb2157-5-2013
Review
Schattauer GmbH

Primary varicosis and venous malformation in the genital area

Therapeutic options Article in several languages: English | deutsch
D. A. Loose
1   Dept. Vascular surgery and Angiology, Hamburg
,
G. Faerber
2   Centre for Vascular Medicine, Hamburg
,
J. Weber
3   Privat Practise, Hamburg
› Author Affiliations
Further Information

Publication History

Received: 13 July 2013

Accepted: 17 July 2013

Publication Date:
04 January 2018 (online)

Also available at
    Permissions and Reprints

Summary

The pathogenesis of primary varicosis and, in particular, congenital vascular malformations in the genital area is determined by haemodynamic and hormonal factors. Both primary varicosis and secondary varicosis in gonadal vein insufficiency can lead to extensive vulvar varicosities with severe congestive symptoms (pelvic congestion syndrome). Congenital venous malformations in the genital area occur both in isolation and in combination with venous malformations of adjacent regions and should be treated as early as possible.

Correspondingly, various treatment approaches have been developed in recent years, whereby currently, after use of interventional radiology in occlusion treatment of the gonadal vein insufficiency, sclerotherapy of the vulvar varicosities is recommended either primarily or supplementary to vascular surgery to remove the venectasias. This also applies to venous malformations in the genital area.

Keywords

Gonadal insufficiency - genital venous malformation - vulvar varicosis - pelvic congestion syndrome - pudendal varicosis
 

  • Reference

  • 1 Browse NL, Burnaud KG, Irvine AT, Wilson NM. Diseases of the veins. London: Arnold; 1999. 1-22 239-240.
    Google Scholar
  • 2 Craig O, Hobbs T. Vulvar phlebography in the pelvic congestion syndrome. Clin Radiol 1975; 25: 517
    CrossrefPubMedGoogle Scholar
  • 3 Cabrera J, Garcia-Olmedo MA, Cabrera jr J, Redondo P. Treatment of venous malformations with sclerosant in microfoam form. Arch Dermatol 2003; 139: 1409-1416.
    CrossrefGoogle Scholar
  • 4 Cabrera JC, Loose DA. Sclerotherapy in Vascular Malformations. In: Mattassi R, Loose DA, Vaghi M. (eds). Hemangiomas and Vascular Malformations. An Atlas of Diagnosis and Treatment Mailand: Springer; 2009: 171-180.
    Google Scholar
  • 5 Deska Th, Mumm A, Geier B, Pennekamp W, Barbera L. Videoskopische Ligatur der linken Vena ovarica bei pelviner venöser Insuffizienz. Phlebologie 2001; 5: 120-123.
    Article in Thieme ConnectGoogle Scholar
  • 6 Dixon JA, Mitchell WA. Venographic and surgical observations in vulval varcose veins. Surg Gynecol Obstet 1970; 131: 458-464.
    Google Scholar
  • 7 Faerber G. Die perkutane Sklerotherapie der Varikose im Genitalbereich. 18. Angiologisches Forum Hamburg, 29.-30.09. 2000
    Google Scholar
  • 8 Guilhen P, Baux R. La Phlebographie Pelvienne par Vois Veineuse, Osseuse et Utérine. Paris: Mass-on et Cie; 1954
    Google Scholar
  • 9 Herbreteau D, Bouret JM, Enjolras O, Merland J. Surgical Treatment of venous vascular malformations of the vulva after in situ embolization. Proceedings of the 11th International Workshop on Vascular Anomalies, Rome, June 23-26, 1996. Suppl. M. n.1al n. 1/1996 della Rivista “Archivio di Chirurgia Toracica e Cardiovascolare”.
  • 10 Krajcar J, Radakovic B, Stefanic L. Pathophysiology of Venous Insufficiency during Pregnancy. Acta med Croatica 1998; 52: 65-69.
    PubMedGoogle Scholar
  • 11 La Page PA, Villavicencio JL, Gomez ER, Sheridan MN, Rich NM. The vulvar anatomy of the iliac venous system and its clinical implications. J Vasc Surg 1991; 14: 678-683.
    CrossrefGoogle Scholar
  • 12 Lechter A. Pelvic and Vulvar Varices: Pelvic Congestion Syndrome. In: Goldmann MP, Weiss RA, Bergan JJ. (eds). Varicose Veins and Teleangiectasias. Diagnosis and Treatment. St. Louis: QMP, Inc.; 1999: 425-448.
    Google Scholar
  • 13 Loose DA, Gottlieb W- R. Die chirurgische Therapie der Varikose im Genitalbereich. Vortrag auf dem 18. Angiologischen Forum Hamburg, 29.-30.09.2000
  • 14 Malkoff JS. Treatment of an Extremely symptomatic groin, pudendal, high inner thigh complex of varicosities with sclerotherapy. Communication at the 19th Annual Congress – Phlebology 2000 October 1 – 3. 2000. New Orleans: Louisiana;
    Google Scholar
  • 15 Marrocco M, Stillo F. Percutaneous sclerotherapy of genital venous Malformations. Communication at the 13th International Workshop on Vascular Anomalies, Montreal. Canada: May 10 – 13 2000
    Google Scholar
  • 16 Marrocco-Trischitta MM, Nicodem EM, Nater C, Stillo F. Management of Congenital Venous Malformations of the Vulva. J Obstet Gyn 2001; 20 (10) 1-5.
    Google Scholar
  • 17 Papendiek C. Atlas Color Temas de Angiologia Pediátrica. Buenos Aires: Editorial Medica Panamericana; 1992
    Google Scholar
  • 18 Rabe E, Pannier-Fischer F. Die pudendale Varikose – eine selten diagnostizierte Entität. Vasomed 1999; 11 (05) 194-196.
    Google Scholar
  • 19 Scultetus AH, Villavicencio JL, Rich NM. Das weibliche Beckenvenensyndrom – eine Übersicht. Phlebologie 2003; 2 :37/13 – 44/22
    Google Scholar
  • 20 Simon E, Kunath E, Göretzlehner G. Varicosis im kleinen Becken bei der gynäkologischen Laparaskopie. Vasomed 1999; 5: 197-201.
    Google Scholar
  • 21 Staubesand J. Kleiner Atlas zur vaskulären Ana-tomie der Leistengegend. In: Brunner U. (Hrsg.): Die Leiste. Diagnostische und therapeutische Aspekte der Arteriologie, Phlebologie und Lymphologie Bern, Stuttgart, Wien: H. Huber; 1979: 11-50.
    Google Scholar
  • 22 Weber J. Pelvines Stauungssyndrom, Vulva- und Beinvarikose in Diagnostik und Therapie. Vasomed 1999; 11: 202-207.
    Google Scholar
  • 23 Weber J, Loose DA. Ovarialveneninsuffizienz, Vulva- und Beinvarikose – diagnostische Abklä-rung und Therapiekonzept. Vortrag auf dem 4. Phlebologentreffen des Phlebologischen Arbeits -kreises Elbe-Havel-Saale, Torgau 15.-16.05.1998
  • 24 Weber J, Loose DA. Diagnostik, Interventionelle und chirurgische Therapie des pelvinen Stauungssyndroms mit Vulva- und Leistenbeteiligung. Vortrag auf dem Kärntner Radiologie Symposium, „Aktuelle Radiologie der Frau“, Velden, Österreich, 26.-28.04.2001.
  • 25 Zubicoa S, Carrión O, Cadena J, Guijo J, Leal J. Embolization Treatment for Patients with Pelvic and Lower limbs venous insufficiency. Communication at the European Congress of the International Union of Phlebology, 26.09.–01.10.1999, Bremen, Germany. In: Rabe E, Gerlach H, Lechner W. (Hrsg). Phlebology 00. Phlebology of the Second Millennium. Köln: Viavital Verlag; 1999: 217-218.
    Google Scholar
  • 26 Weber J. Phlebographie. Bein-, Becken- und Abdominalvenen in Anatomie und Funktion. Bonn: Rabe Verlag; 2010: 327-348.
    Google Scholar
  • 27 Loose DA, Mattassi R, Vaghi M. Gefäßmalformationen. In: Debus ES, Gross-Fengels W. (Hrsg). Operative und interventionelle Gefäßmedizin. Berlin: Springer; 2012: 769-791.
    Google Scholar
  • 28 Lee BB, Bergan J, Gloviczki P, Laredo J, Loose DA, Mattassi R, Parsi K, Villavicencio JL, Zamboni P. Diagnosis and treatment of venous malformations: Consensus document of the International Union of Phlebology (IUP)-2009. Int Angiol 2009; 28 (06) 434-451.
    Google Scholar
  • 29 Krokidis M, Venetucci P, Hatzidakis A, Iaccarino V. Sodium Tetradecyl Sulphate direct intralesional sclerotherapy of venous malformations of the vulva and vagina: report of five cases. Cardiovasc Intervent Radiol 2011; 34: 228-231.
    CrossrefGoogle Scholar
  • 30 Kulungowski AM, Schook C, Alomari AI, Vogel A M, Mulliken JB, Fishman SI. Vascular anomalies of the male genitalia. J Pediatr Surg 2011; 46: 1214-1221.
    CrossrefGoogle Scholar
  • 31 Geier B, Mumme A, Asciutto G, Marpe B, Köster O, Barbera L. Pelvine Insuffizienz und Varikosis der unteren Extremität. Phlebologie 2006; 35: 243-248.
    Article in Thieme ConnectGoogle Scholar