New Clinical Grading for Varicose Veins of Vulva

Varicose veins of the vulva and vagina are thought to affect somewhere between 100,000 and 500,000 women in the UK, and countless more in the USA, Europe and the rest of the world.

The usual advice given to women with this problem is that "nothing can be done about it" or to wear tight supportive underwear.

However developments over the last decade at The Whiteley Clinic have shown that this condition can be treated with a combination of embolisation of the pelvic veins causing the problem and then foam sclerotherapy of the veins themselves.

In order to choose the right treatments, a grading system is needed to know how severe the veins are. The Whiteley Clinic grading system for varicose veins of the vulva has therefore was introduced in 2011 and has been recently published (2012).

	Description	Frequency seen at present
Grade 0	Normal – no varicosities nor venous reflux in vulva	Usual
Grade 1	No visible varicosities in vulva, but ultrasound proven reflux in vulval veins usually with para-vulval varicose veins seen on inner thigh	Common – 1 in 7 females presenting with leg varicose veins (1 in 5 of those post vaginal delivery)
Grade 2	Visible varicosities seen through mucosa of inner labia and lower vagina and ultrasound proven reflux in vulval veins.	Uncommon
Grade 3	Isolated varicosities seen on standing through skin of outer labia majora without a distortion of the general anatomy of the area	Very uncommon
Grade 4	Extensive varicosities of the labia, distorting skin and distorting the gross anatomy of the area on standing	Rare

If you want to see more about this scale, it was first published in:

The treatment of varicose veins of the vulva and vagina. by MS Whiteley
In: Greenhalgh RM (Ed.) Vascular and Endovascular Controversies Update. London Biba Publishing, 2012 p. 666-670


For more information about varicose veins of the vagina or vulva see: www.vulval-varicose-veins.co.uk