S/P sclerotherapy of labial varicose vein

The answer is yes. Sclerotherapy of larger varices can successfully close the vein but sometimes a bit of trapped blood which clots results in a firm tender vein.  While this is not dangerous and will heal with time, draining the affected area often improves healing time and relieves the pain and discomfort.  NSAIDS like ibuprofen and warm compresses may also help.

We tell our patients to *expect* to need to have some removed in 3-6 weeks depending on the size of the vein. 

Yes, this is very common in larger vein sclerotherapy. The trapped blood can be evacuated with a needle and syringe and significantly speed up recovery time. 

What your were told is exactly correct.  Sclerotherapy will cause some veins to clot and the trapped blood within the vein causes the hard "lump".  This can be drained by popping it as if popping a pimple.

What you are experiencing is a normal part of the healing process and is nothing to be concerned about. When we perform sclerotherapy, the larger a vein is, the greater the potential for there to be trapped blood in the vein as it shrinks down, which is essentially a small clot. Your body will reabsorb this all on its own, but due to the volume it may take some time. To speed up the process we can help reduce the load of the trapped blood by performing a needle aspiration, where we poke a tiny needle into the vein, and try to express or flush out the old blood. Using hot, moist compresses will also help, and certainly using over the counter NSAID's can reduce any tenderness. 

It is a clot and should be easily drained. This is however not a final solution for the condition. Labial veins are associated with what is called the pelvic congestion syndrome, abdominal pains mainly when standing and dyspareunia or painful intercourse. The problem is caused by the reversal of flow from one of the major pelvic veins ( mostly ovarian vein) into your labia veins, even upper inner thigh veins or veins that "start" in the buttock area.
If the condition is bothering you, and only then, the best treatment is consulting with a doctor, and being referred to a interventional radiologist. He can diagnose the condition and treat it same time too by stopping the reversal of flow at it's actual source. This is an invasive procedure and I would consider it only if the condition is severe. I have no idea of your age but a pregnancy can make your life quite miserable.

Yes these are effectively treated using sclerotherapy.  There can be small areas of trapped blood which can be tender and hard to touch.  They will resolve in time.  You can apply low heat often, take an NSAID (Advil etc) course for 5 or so days.  However, if too uncomfortable, they can be drained.   They typically don't show up until 10-14 days.  

Yes, this is correct,  This is not an uncommon adverse reaction to sclerotherapy of larger varicosities (as opposed to treating spider veins) called retained coagulum.  The Sotradeol has killed the vein but blood has gotten into the vein and clotted.  This is not dangerous like a clot in a deep vein or DVT but it can be uncomfortable.  It will typically go away with time but may get better quicker if the clot can be expressed.

It is common to have some firmness in treated veins flowing sclerotherapy, and clot formation is a natural consequence of placing sclerosant in a vein. If the vein is symptomatic and bothering you, yes, the clot may be removed through a small nick. Unless your treating physician has other reasons to remove the vein, though, you could potentially just try using heating pads and ibuprofen to help your symptoms. Tincture of time will often solve these issues, although I defer to the expertise and judgement of someone who can assess your veins in person. Good luck and I hope this helps! Dr Jensen