Minimally Invasive Surgical Treatment of Pelvic Leak Points

Pelvic leak points are responsible for reflux and visible varicose veins in 8.3% of all cases, as found in a nonpublished series of 4.411 CHIVA treatments, where the author found 366 cases of pelvic reflux: 90% of them in women (free of pelvic congestion syndrome). Analysing the pathway, six well-defined parietal pelvic leak points (PLPs) may be detectable on each side: the perineal point (PP), the inguinal point (IP), the obturator point (OP), the gluteal points (superior, SGP, and inferior, IGP) and the clitoridian point (CP). Perineal and inguinal points (PP and IP) represented 97% of all treated PLP in women. The PLPs are detectable, thanks to accurate duplex imaging assessment, and selected for surgery when refluxing at Valsalva test. They can be treated with mini-invasive surgery under local anaesthesia.