Surgical treatment of vulvar venous malformations without preoperative sclerotherapy: Outcomes of 18 patients
| Autor: | Francesca Toni, Nikos Paraskevas, Pierre Cerceau, Annouk Bisdorff, Claude Laurian, Claudine Massoni |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Vascular Malformations medicine.medical_treatment Pain Vulva Veins 03 medical and health sciences Young Adult 0302 clinical medicine Quality of life Sclerotherapy Internal iliac vein Medicine Humans Vein Child Aged Retrospective Studies 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Soft tissue Middle Aged Surgery Clitoral hood medicine.anatomical_structure Dyspareunia Reproductive Medicine 030220 oncology & carcinogenesis Female business Ovarian vein |
| Zdroj: | Journal of gynecology obstetrics and human reproduction. 50(6) |
| ISSN: | 2468-7847 |
| Popis: | Background Our aim was to evaluate the benefit of surgical resection of the venous malformations (VMs) of the external female genitalia. Methods Over the period of 2009–2019, 18 consecutive females underwent surgical resection for vulvar VM. Evaluations included preoperative Doppler ultrasound, MRI, and pre-and postoperative photographic imaging. The main outcomes were: residual pain, cosmetic distortion, residual VM, and quality of life. Results Over a 10 year periods, 18 females, mean age 35 years (range 9–71) were included in this study. All patients were symptomatic: 16 had intermittent pain or discomfort, 1 had bleeding and 2 requested cosmetic treatment. Of these cases, there were 5 isolated vulvar VM, 12 associated VM: 3 of the clitoral hood, 3 troncular pelvic vein insufficiency and 12 of the lower limb. Eight patients had undergone previous procedures: 2 sclerotherapy treatments (1–3 sessions), 4 partial surgical resections. There were 18 single resections in the vulva (7 focal, 11 complete), 2 partial resections in clitoral hood and 2 had resection of a VM in the perirtoneovaginal canal at the same time. The mean follow-up was 42. 9 months (range 6–120). Two patients were lost to followup at 6 months. For all patients, elimination of pain and soft tissue redundancy was achieved. Two patients had persistent discomfort and 2 requested cosmetic treatment. Conclusion Surgical resection of vulvar VM can be the best approach with few postoperative complications, good functional and cosmetic results. Appropriate preoperative evaluation is required to identify isolated VM or VM associated with ovarian vein or internal iliac vein insufficiency requiring to be treated before surgery. |
| Databáze: | OpenAIRE |
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