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Vulval lesion investigation

Published by Bupa's health information team, July 2008.

This factsheet is for women who are planning to have a vulval lesion investigated, or who would like information about it.

Vulval lesion investigation is a procedure to find out what an abnormal growth or lump on your vulva might be.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

About the vulva
Preparing for your procedure
About the procedure
What to expect afterwards
Recovering from vulval lesion removal
What are the risks?
Further information
Questions and answers
Related topics
Sources

About the vulva

The vulva includes all the visible female sex organs. There are two outer lips (the labia majora) which are covered in pubic hair, two thinner inner lips (the labia minora) and the clitoris at the front. A vulval lesion may be anywhere in this area. You may be able to see it, and you may have symptoms including vaginal itching, discharge, redness and pain during sex.

Vulval lesions are usually removed by a gynaecologist (a doctor specialising in women's reproductive health). Your GP will usually refer you to the gynaecologist.

Preparing for your procedure

Your surgeon will explain how to prepare for your procedure.

The procedure is usually done in out-patients under local anaesthesia. Local anaesthesia completely blocks feeling in the vulval area and you stay awake.

At the hospital, your surgeon will explain the procedure and usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

About the procedure

The procedure to remove a vulval lesion usually takes about 30 minutes, depending on how many lesions there are and whether your surgeon is removing them completely.

A female nurse will stay with you throughout the procedure.

Some anaesthetic cream is usually applied close to the lesion. This numbs the skin so that local anaesthetic can be injected into the vulva more comfortably.

Your surgeon will usually use a scalpel to remove the lesion or part of it. Whether or not your surgeon decides to remove the whole lesion depends on its size and shape - if it is quite large, for example, it's more likely that only a small piece will be taken for testing. If your surgeon decides to remove the whole lesion, some healthy skin surrounding the lesion may also be removed to make sure the entire lesion is gone.

The wound is closed with dissolvable stitches. A dressing isn't usually needed.

The lesion is sent to the laboratory for testing. The tests will find out whether it's a harmless lump or cancer. The test results will help your surgeon decide if you need any further treatment.

What to expect afterwards

You will usually be able to go home when you feel ready. Your nurse will give you some advice about caring for your healing wound before you go home. You may be given a date for a follow-up appointment.

Recovering from vulval lesion removal

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

You need to keep the healing wound as dry as possible. It's better to have a shower rather than a bath and carefully dab the area dry afterwards.

Your healing wound may bleed slightly. You can usually stop the bleeding by gently pressing a clean gauze pad against the wound. If you have any of the following symptoms contact your GP as you may have developed an infection:

prolonged, heavy bleeding
severe pain
high temperature
vaginal discharge that is dark or smells unpleasant

It is best to wear cotton underwear and loose clothing (no tights, for example) and not to use talcum powder until your stitches have dissolved. Dissolvable stitches will disappear or fall out on their own in seven to ten days.

You should be able to return to your usual activities within a day or two.

Sexual intercourse can be resumed when you feel ready. You should continue to use your usual form of contraception unless advised otherwise.

What are the risks?

Vulval lesion investigation is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.

The vulval area may feel sore for a few days and the healing wound may bleed slightly.

Complications

This is when problems occur during or after the procedure. Most women are not affected. The possible complications of any surgery include excessive bleeding during or soon after the procedure, infection, and an unexpected reaction to the anaesthetic.

The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.

Further information

Cancerbackup
0808 800 1234
www.cancerbackup.org.uk