Pelvic Venous Reflux in Males with Varicose Veins and Recurrent Varicose Veins

Background: To report on a male cohort with pelvic vein reflux and associated primary and recurrent lower limb varicose veins. Method(s): Full lower limb duplex ultrasonography revealed significant pelvic contribution in eight males (3% of those presenting during the time period) presenting with bilateral lower limb varicose veins. Testicular and internal iliac veins were examined with either one or a combination of computed tomography, magnetic resonance venography, testicular, transabdominal or transrectal duplex ultrasonography. Subsequently, all patients received pelvic vein embolisation, prior to leg varicose vein treatment. Venography and Cross sectional Imaging depicts reflux from not only the internal iliacs but the testicular veins communicating avidly with the legs. Result(s): Pelvic vein reflux was found in 23 of the 32 truncal pelvic veins and these were treated by pelvic vein embolisation. Four patients have since completed their leg varicose vein treatment and four are undergoing leg varicose vein treatments currently. Conclusion(s): Pelvic vein reflux contributes towards lower limb venous insufficiency in 3% males with leg varicose veins. Despite the challenges, we suggest that pelvic vein reflux should probably be investigated and pelvic vein embolisation considered in such patients to reduce risks of recurrence.

 

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Publication History

Article published online:
11 May 2021