VULVARICOSITY: FEATURES OF DIAGNOSIS AND TREATMENT IN PATIENTS WITH VARICOSE VEINS AND PREGNANT WOMEN

Аннотация

Introduction: Vulvar varicose veins (VV) represent a form of venous pathology often associated with pelvic varicose disease (PVD) and pregnancy. VV may cause discomfort, swelling, cosmetic issues, and even complications like thrombophlebitis. Accurate diagnosis and tailored treatment are essential for effective patient management. Methods: A total of 101 women were examined, including 61 patients with PVD and VV, and 40 pregnant women with VV. Diagnostic methods included clinical examination, duplex ultrasound, multislice CT, ovarian vein phlebography, and emission CT. Venous anatomy and reflux severity were assessed. Treatments involved surgery (phlebectomy, gonadal vein resection, sclerotherapy) and conservative therapy (venotonics, compression hosiery, topical agents). Results: In the PVD group, VV was associated with less frequent pelvic pain (31%) and more frequent gonadal/pelvic vein reflux. In pregnant women, VV had a systemic pattern with frequent involvement of the external pudendal vein. Sclerotherapy was effective for isolated VV (<6 mm), while surgical treatment was indicated for pelvic venous reflux. After delivery, 80% of pregnant patients experienced spontaneous regression of VV. Duplex ultrasound proved highly effective in diagnostic planning. Discussion: Different forms of VV require individualized treatment strategies: surgical treatment is suitable for PVD cases, while conservative therapy is preferred during pregnancy. Modern imaging modalities help precisely evaluate venous anatomy and inform optimal therapeutic decisions.