Varicose veins in men can arise from pelvic varicose veins.
Most people consider varicose veins to be a leg problem.
As most surgeons in the UK do not look for pelvic varicose veins, it is not surprising that this is a major cause of recurrence after “treatment”.
However, until recently, this was thought to be a female only problem.
A recent research paper from The Whiteley Clinic reported 8 men who had varicose veins.
Seven of the eight had previously had varicose vein surgery elsewhere. Their veins had recurred. Duplex ultrasound scans confirmed that a major cause of their recurrence was from pelvic varicose veins. One of these patients had such bad varicose veins they even had a leg ulcer.
All eight patients pelvic veins symbolised as a part of their treatment. Each of the patients had a good outcome from their surgery. The patient with a venous leg ulcer found that it healed completely after the treatment.
People commonly say that “varicose veins are only cosmetic”. Research has shown that this is wrong.
The REACTIV trial was pivotal in changing this view. Patients with varicose veins were divided into 2 groups. The first group had surgical treatment. The second had “best medical treatment” – compression stockings. Within two years, the group that did not have surgery was quality of life than the group that did have surgery.
The surgery in this study was the old “vein stripping”. With the new endovenous surgery, which is less traumatic and has a faster return to normal activity, the difference in the quality of life is likely to be even more pronounced.
Furthermore, it has been shown that almost 1 in 20 people with varicose veins will deteriorate each year. These stages of deterioration of from varicose veins to swollen ankles, then skin damage and finally venous leg ulcers. Other complications of leaving varicose veins and treated include clots (superficial venous thrombophlebitis or “phlebitis”) or bleeding.
It is for these reasons that the National Institute of Health and Care Excellence (NICE) now supports surgery for varicose veins. They recommend that anyone with varicose veins and symptoms or signs should be referred for treatment.
Most people would be surprised to hear that men can have varicose veins in their pelvis. However, most people do know that men can get haemorrhoids (piles). These are only varicose veins arising from the pelvis. Many people will also have heard of a “varicocele”. This appears as a varicose vein around the testicle. Although these two sorts of pelvic veins are visible externally, it transpires from ultrasound scanning that other pelvic varicose veins also exist.
Currently, The Whiteley Clinic is researching all of these. However, this paper relates only to the pelvic varicose veins that communicate and feed leg varicose veins.
It appears to be the first paper ever to show that leg varicose veins in males can originate from pelvic varicose veins. It only appears to happen in about 3% of men. However, failure to identify and treat these cases will probably result in failed varicose vein surgery and recurrence in these men.
We encourage all varicose vein doctors to understand pelvic varicose veins in both men and women and to learn how to diagnose and treat them.
Link to explanation of the paper on Kudos: https://link.growkudos.com/1jqyeu0r9c0