The problem vulva

 

Should I see a gynaecologist?

The following symptoms indicate that you might benefit from consulting with a gynaecologist:

  • Soreness
  • Burning
  • Itching
  • Pain
  • Lumps / warts
  • “Abnormal vulva”
  • Ulceration
     

What will happen at my appointment?

  • Discussion of your history - gynae, medical, family, social
  • Examination
  • Diagnostic investigation - vulvoscopy +/- colposcopy  +/-  biopsy
  • Treatment and advice
  • Follow-up
     

What are the possible causes of my vulval pain?

  1. BENIGN LESION
     

  2. MALIGNANT INTRAEPITHELIAL NEOPLASIA (VIN) - refers to changes that can happen in the skin that covers the vulva. VIN is not cancer, and in some women it disappears without treatment. However, it may develop into cancer after many years, so VIN is known as a pre-cancerous condition.
     

  3. INVASIVE MALIGNANT NEOPLASIA – very rare genital cancer mostly seen in women over 60 years.
     

  4. VULVODYNIA - defined as chronic vulval discomfort, most often described as a burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable, neurological disorder. 

 

What are the treatment options?

  • General - counselling, support, vulval hygiene, treat medical problems
  • Medical - dermovate, dermol etc
  • Surgical - exc. biopsy, Co2 laser, diathermy
     

Summary

Vulval problems are very common but potentially serious.  Diagnosis of vulval problems is very difficult as 30% of patients have more than one problem.  A biopsy essential unless very obvious cause or prepubertal.

 

Do you have any questions?

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