Treatment of Vaginal Varicosities

Vaginal varicosities are superficial blood vessels that are often located just cranial to the vestibulo-vaginal fold. The vessels may spontaneously rupture causing blood to exit from the vulva. The treatment of varicosities includes benign neglect, topical treatment with astringent creams, ligation of vessels, cautery of vessels, and laser photocoagulation of vessels. If bleeding from the vulva is present, the source of the bleeding should be determined by the use of a vaginal speculum or an endoscope passed into the vagina. The endoscope may be retroflexed back toward the vulva to examine the inner aspect of the vestibulo-vaginal fold for varicosities. This chapter discusses techniques for endoscopic examination and laser photocoagulation of varicosities using an Nd:YAG laser.