Treatment of vaginal varicose veins and vulval varicose veins:
Experience from The Imaging Clinic working with The Whiteley Clinic in well over 1000 patients by the end of 2011, the optimal technique was found to be an approach from the neck.
Under ultrasound guidence, a local anaesthetic is injected into the skin in the neck and a coil embolisation device passed under x-ray control down through the veins and into the ovarian or internal iliac veins as required.
Once in position, a coil or other embolisation device can be pushed out into the veins, closing them and stopping any further reflux. This treatment should be permanent if the correct embolisation devices are used.
Once the pelvic vein reflux has been eliminated, the patient is rescanned with a transvaginal duplex ultrasound scan at six weeks to check that the treatment has been successful. Provided it has been, the vaginal or vulval varicose veins can then be treated by injection of foam sclerotherapy either directly into the vaginal or vulval varicose veins, or under ultrasound guidence if they are not obvious.
In the past, there have been reports of other attempted treatments for vaginal varicose veins or vulval varicose veins including direct removal of the veins themselves or foam sclerotherapy without embolising the underlying cause first. In exactly the same way that one would not treat varicose veins in the legs without treating the underlying cause first, if the vaginal varicose veins or vulval varicose veins are treated without identifying and treating the pelvic vein reflux first, the veins will just come back again shortly after treatment.
What you should do if you have vaginal varicose veins or vulval varicose veins
You should not accept any advice that suggests that it is only cosmetic or can be treated by wearing compression garments or pants.
You should be seen by a vein expert with experience in the field and have a transvaginal duplex ultrasound scan performed by an expert who does them regularly. MRI scans CT scans and venography are not adequate for optimal treatment.
On the results of the transvaginal duplex ultrasound, you should have a transjugular (across the neck) embolisation of the veins under x-ray control which will stop the underlying cause. This will then almost always be followed by ultrasound guided foam sclerotherapy after a few weeks.
By insisting on seeing an expert in this area, there is no reason that you shouldn’t expect a cure from this condition, with very little chance of it recurring in the future.