PELVIC AND PERIPHERAL VENOUS INSUFFICIENCY: DIFFERENT PRESENTATIONS AND COMMON PATHOPHYSIOLOGY

Introduction: Varicose veins are related to other diseases including varicocele or utero-ovarian varices. On the base ofclose physiopathologic relationships between varicose veins and gonadal varicosity we decided to evaluate the featuresof pelvic venous insufficiency in patients affected hy varicose veins.Methods: Seventy patients with different grades of chronic venous insufficiency (CVI) were included in the study. Thepatients were evaluated pre-operatively by color Doppler for grading of gonadal varicosity and assessment of valvularincompetence in the peripheral veins. Post-operatively, the number of valves in the stripped veins was correlated to thedegree of gonadal varicosity.Results: Thirty patients were proved to have both peripheral and pelvic venous insufficiency. Higher grades of gonadalvarices were associated with lesser number of saphenous valves. There was a significant relation hetween the Dopplergrading of venous reflux in gonadal & peripheral veins.Conclusions: The incidence of varicocele associated with CVI was higher than the incidence of isolated varicocele.The bilateral development of gonadal and peripheral varicosity in female patients refers to mechanical compressionfollowed by axial reflux. The association of lesser number of valves in the saphenous veins with higher grades ofvaricocele raises the possibility of generalized valvular scarcity as a cause of venous insufficiency.