[The external pudendal veins. An anatomo-clinical study, their treatment by ambulatory phlebectomy (Muller method)]

Forty-one cases of E.P. varices (bilateral in 3 cases) were identified after examining 1371 patient histories followed up between 1985 and 1989 inclusive, i.e., 2.99 percent. Analysis of the history, clinical signs and Doppler and arguments based on the practice of ambulatory phlebectomy of the thighs made it possible to establish an accurate anatomical description of these somewhat poorly understood venous territories: simple or complex origin, principal or secondary saphenous ending and non-saphenous endings, supramelic, para-public, labial and perineal connections, extensions into other territories, defining major EP varicoses. Physical-pathological investigation can establish the frequently autonomous nature of these EP varicoses. The high incidence of primary reflux, their wide distribution along the varicose axes prolonged over 1 to 3 segments of the limbs, characterize the 37 cases of major EP varicosis. Therapeutic analysis reveals: the inadequacy of surgery and sclerosis in severe cases, the efficacy of ambulatory phlebectomy (A.P.) AP presents specific characteristics of method and bandaging related to the quality of the skin and venous tissue and the EP site. Thirty APs were carried out with very good anatomical, functional and aesthetic results.