PELVIC AND PERIPHERAL VENOUS INSUFFICIENCY: DIFFERENT PRESENTATIONS AND COMMON PATHOPHYSIOLOGY

Document Type : Original Article

Authors

1 Mansoura University Hospital, Departments of Vascular surgery

2 Mansoura University Hospital, Departments of Radiology

3 Mansoura University Hospital, Departments of and OB/GYN

Abstract

Introduction: Varicose veins are related to other diseases including varicocele or utero-ovarian varices. On the base of
close physiopathologic relationships between varicose veins and gonadal varicosity we decided to evaluate the features
of 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. The
patients were evaluated pre-operatively by color Doppler for grading of gonadal varicosity and assessment of valvular
incompetence in the peripheral veins. Post-operatively, the number of valves in the stripped veins was correlated to the
degree of gonadal varicosity.
Results: Thirty patients were proved to have both peripheral and pelvic venous insufficiency. Higher grades of gonadal
varices were associated with lesser number of saphenous valves. There was a significant relation hetween the Doppler
grading 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 compression
followed by axial reflux. The association of lesser number of valves in the saphenous veins with higher grades of
varicocele raises the possibility of generalized valvular scarcity as a cause of venous insufficiency.

Keywords

The Egyptian Journal of Fertility of Sterility
Volume 10, Issue 1
January 2006
Pages 45-59

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