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Sclerotherapy treatment of a large venous malformation invading the bladder wall related to Klippel-Trenaunay syndrome
  1. Luke Foster1,
  2. Narayan Karunanithy2,3 and
  3. Ramesh Thurairaja4
  1. 1Department of Urology, Royal Free London NHS Foundation Trust, London, UK
  2. 2Department of Interventional Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  3. 3Department of Biomedical Engineering and Imaging Sciences, School of Biomedical Sciences, King's College London, London, UK
  4. 4Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Luke Foster; luke.foster{at}doctors.org.uk

Abstract

We report the case of a 35-year-old woman who presented with recurrent macroscopic haematuria and known diagnosis of Klippel-Trenaunay syndrome. Imaging and cystoscopy identified an extensive venous malformation involving a large area of the bladder wall. Holmium laser therapy was ineffective at obtaining symptom control. Following a multidisciplinary team meeting, transvenous sclerotherapy with sodium tetradecyl sulphate was performed under image guidance. A reduction in venous density was observed on cystoscopy and the patient has had complete resolution of symptoms within 6 weeks and continued to be asymptomatic up to 24-month follow-up. We propose that transvenous sclerotherapy is considered first-line treatment in this clinical setting.

  • urology
  • urological surgery
  • hematuria
  • interventional radiology

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Footnotes

  • Twitter @narayan_karu

  • Contributors RT was the lead surgeon for the patient, initiating the case report, guiding key points, reviewing drafts and the final edit. NK performed the transvenous sclerotherapy. NK and LDF performed a literature review, wrote the body of text and selected/edited images.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.