Management of congenital venous malformations of the vulva

Obstet Gynecol. 2001 Nov;98(5 Pt 1):789-93.


Objective: To discuss the differential diagnosis and the management of venous malformations of the vulva.

Methods: Five symptomatic patients were treated. The degree of pain and discomfort was self-assessed by using a horizontal visual analog scale before and after treatment. Preoperative evaluation included Doppler ultrasound scanning in all patients and magnetic resonance imaging (MRI) in one. All patients had direct-injection venography and sclerotherapy during the same session. Ethanol was used in two cases and polidocanol in three. Patients were followed-up by means of Doppler ultrasound scanning and office visits.

Results: All patients experienced marked swelling after the injection, and one developed cutaneous necrosis that healed within 2 weeks. Transient hemoglobinuria was observed in two cases. No early or late major complications occurred. At a mean follow-up of 23 months (range 5-43), all patients experienced complete relief from symptoms and currently have normal vulvar sensation. Four patients had complete ablation of the treated lesion. In one patient the procedure resulted in a significant, albeit incomplete, occlusion of the lesion, and no further treatment was deemed necessary. From a cosmetic standpoint, both patients and physicians considered the results successful.

Conclusion: Vulvar venous malformations should be distinguished from vulvar varicosities, hematomas, soft-tissue neoplasms, and other vascular anomalies. Doppler ultrasound, MRI, and direct-injection venography are the most accurate diagnostic modalities. Sclerotherapy can successfully treat this condition. The procedure should be monitored with an imaging modality, preferably direct-injection venography with digital subtraction serial imaging.

MeSH terms

  • Adult
  • Ethanol / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Pain Measurement
  • Polidocanol
  • Polyethylene Glycols / therapeutic use
  • Sclerosing Solutions / therapeutic use
  • Sclerotherapy*
  • Time Factors
  • Veins / abnormalities*
  • Vulva / blood supply*


  • Sclerosing Solutions
  • Polidocanol
  • Ethanol
  • Polyethylene Glycols