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Is surgery the only option for varicose veins?

Q: I am 47 years old and have varicose veins on my left leg for the last 15 years. Of late, I have been having a feeling of heaviness in the legs and pain in the ankles. I consulted a doctor who advised surgery (laser or RF). I would like to know whether surgery is the only remedy? Will they recur after surgery in the same leg or the other one? Can I walk freely, drive the car, exercise, lift weights, etc?

A:You have posed three questions. 1. The first is if surgery is the only treatment. No, surgery is not the only treatment. There are other modes of treatment, which are either non-invasive or less invasive. The compression hosiery (graduated compression stocking), sclerotherapy, then of-course the treatment with laser and radio-frequency endovenous ablation, SEPS and lastly the surgery. You have to be assessed and the appropriate treatment advised which may be surgery or any of the other modalities. There is no doubt that if surgery is the best treatment advised then it is best to take that advice, as other treatments may be less effective. Many times the various modalities have to be combined to get the maximum benefit. 2. The answer to the second question is that there is always a possibility of recurrence in the same leg or the other leg. Some percentage of recurrence is inevitable, this is irrespective of the modality of treatment or the treatment centre. This also depends on the original status of the venous valves and the presence or absence of the other venous pathology, e.g. Chronic Venous Hypertension. 3. The third question, even though not specified I presume relates to the activity after the operation. Most certainly one should be able to do all the usual activities after the period of 6 - 8 weeks, which is the time it takes for the bruising to settle. Lastly the best results are achieved by a well-trained operator making a thorough assessment in an individual case and employing a tailor-made treatment to suit an individual patients needs.

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