Склерооблитерация вульварных вен - альтернатива флебэктомии в промежности?

Objective. Evaluation of the effectiveness of sclerotherapy and phlebectomy for vulvar varicose veins, determining indications for these therapeutic techniques. Material and methods. The study was based on the results of examination and treatment of 59 patients with vulvar varicose veins (VVV). In addition to varicose syndrome VVV was characterized by pain and swelling of the labia. All patients underwent ultrasound scanning (US) of the pelvis, perineum and lower limbs veins. Varicose veins of the pelvis was diagnosed in all patients, varicose disease of lower limbs (VDLL) in 32 women. Sclerotherapy of vulvar veins as a primary method of treatment was used in 27 patients with VVV (group 1). 1% ethoxysclerol solution or 0.5% solution of fibrovein, 2 ml syringes and 28G needles were used. The varicose vein was punctured, 1 ml of the drug was injected after the appearance of blood meniscus. Phlebectomy in the perineum and lower extremities was performed in 32 patients with VVV and VDLL (group 2). The removal of varicose veins of the vulva was performed through 2 small (phlebectomy. Results. A clear connection between vulvar and intrapelvic veins was not revealed in any of cases during US. In some patients the US established the connection with the tributaries of the great saphenous vein (GSV). The results of this study showed high efficiency of sclerotherapy and phlebectomy in the treatment of vulvar varicose veins. The development of GSV thrombophlebitis or thrombosis of intrapelvic veins were not noted in any of patients in whom sclerotherapy of vulvar veins was performed. This fact suggests that sclerotherapy of vulvar veins is an effective, safe and cosmetic method of treatment and can be used as an independent method of treatment of this condition and in combination with phlebectomy of lower limb in patients with VVV and VDLL. In the presence of large conglomerates of varicose veins of vulva with a diameter of 1 cm or more, the connection of the veins of the external genitalia with modified varicose veins in the lower extremities according to the US data, the surgical method should be preferred. Conclusion. Method of sclerotherapy of vulvar veins should be widely used in clinical practice. This will reduce the invasiveness of the surgery in patients with VVV and VDLL, increase the cosmetic effect of treatment in patients with isolated dilatation of the external genitalia veins, excluding surgery on the perineum veins.