Successful embolization of vulval varices arising from the external pudendal vein(†)

Varicose veins in the vulvar and peri-vulvar area are seen in 4% of women and most commonly seen during pregnancy. It is thought to be as a direct result of the presence of ovarian and pelvic varicosities. Diagnostic modalities used in the investigation of this condition included pelvic ultrasound, computed venography, magnetic resonance venography and catheter-directed venography. The treatment options in the past were hysterectomy and/or ligation of ovarian veins by open or laparoscopic approach. Modern techniques involve embolization of the varicosity via radiological techniques. In this case the patient presented with vulval and upper thigh varices associated with pelvic pain. They were located to be from the superficial external pudendal vein, which is not a common source but worth considering with other causes. They were treated successfully with fluoroscopy-guided embolization.