What is it about?
Varicose veins, whether visible or “hidden”, affect about 30% of the adult population. The recurrence rate after varicose vein surgery is high. Research from The Whiteley Clinic has shown that in females, a major cause of this was pelvic varicose veins. 1 in 6 (16%) females with leg varicose veins actually have varicose veins in the pelvis, causing the leg varicose veins. As most varicose veins surgeons only treat the legs, it is not surprising that there is a high recurrence rate. This paper showed that 1 in 30 (3%) of males have the same problem. In these men, their leg varicose veins actually come from pelvic varicose veins.
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Why is it important?
Recurrence of varicose veins after traditional surgery is common. Indeed, it is often quoted that “varicose veins ALWAYS come back”! Research from The Whiteley Clinic over the last two decades has shown that this is not true. One by one, the causes of recurrent varicose veins have been identified and measured introduced to counteract them. These measures are incorporated into The Whiteley Protocol. It has previously been shown by The Whiteley Clinic that the failure of most doctors to identify and treat pelvic varicose veins is a major cause of recurrent varicose veins in women. This current study reported eight men with leg varicose veins. All were shown to have a major contribution to their leg varicose veins from pelvic varicose veins. These eight men represented 3% of the total males seen with varicose veins and recurrent varicose veins over the same time period. Of note, 7 of the 8 had recurrent varicose veins, suggesting that the failure of identifying this problem and treating it might have contributed to the recurrence. In addition, one patient had a venous leg ulcer that was resistant to compression. Treatment of the pelvic vien and leg varicose veins resulted in healing of the leg ulcer. This is a new finding as pelvic varicose veins causing leg varicose veins had not been previously recognised as a problem in males. This study suggests that in 3% of men who have varicose veins or recurrent varicose veins, there is a major contribution to their problem from pelvic veins. It is suggested that this should be looked for and, if found, the pelvic veins should be treated before treating the leg varicose veins. Failure to do this is likely to result in an increased risk of recurrence after treatment.
Perspectives
This study is one of the most important studies about varicose veins to be published for a while. It is only relatively recently that doctors specialising in varicose veins have realised that pelvic varicose veins are a major cause of leg varicose veins in females. Most varicose vein doctors still do not check for pelvic varicose veins in women, with the consequence that many of these women will get recurrent varicose veins in the future that could have been avoided. It had previously been thought that because of the difference in pelvic anatomy, males did not get pelvic varicose veins and pelvic congestion syndrome. This study shows this to be incorrect. Because of this study, we now know that men can have pelvic varicose veins that communicate with leg varicose veins. Doctors treating patients with varicose veins and associated conditions such as venous leg ulcers must be aware that the problem may stem from pelvic veins. If there is any sign of a pelvic vein problem, this should be investigated and treatment of the pelvic vein should be considered as part of the varicose vein cure.
Professor Mark S Whiteley
The Whiteley Clinic
Read the Original
This page is a summary of: Pelvic venous reflux in males with varicose veins and recurrent varicose veins, Phlebology The Journal of Venous Disease, August 2017, SAGE Publications,
DOI: 10.1177/0268355517728667.
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