Vulvar biopsy is performed when a woman experiences persistent vulvar itching, pain, or a suspicious lesion. Biopsy of vulvar lesion is necessary for histology analysis, to differentiate benign from cancerous (neoplastic) lesions and it may be curative if the entire lesion is removed for biopsy. Vulvar biopsy is relatively minor and it is done under local anesthetic. Initially women may feel a wasp or bee sting or sharp pain during the injection of anesthetic to the vulvar area, then some burning. This usually lasts more than a few seconds.
Most practitioners use a Keyes-type punch biopsy instrument to obtain a specimen of at least 3mm, but a Kevorkian or Kraus biopsy forceps could also be used. In the case of a single lesion to be completely excised, a scalpel is used. Bleeding in small biopsy sites of less than 5mm is stabilized by applying pressure. Silver nitrate is also applied to biopsy site to prevent infection and promote healing. However, vulvar biopsy with larger lesions should be reapproximated with suture. After the procedure, the patient should be taught about sitz baths to keep the area clean and use of oral over-the-counter analgesics.
Complete healing could take 2-3 weeks. A follow-up appointment with your doctor should be scheduled within two weeks to check biopsy site healing and review pathology and culture results.
Reference:
Heller, D & Wallach, R. (2007).Vulvar Disease: A Clinicopathological Approach. CRC Press
Hi John.i got the chance of assisting women who underwent vulvar biopsy when i was in the crevical cancer vaccine research. We usually perform punch biopsy to remove samples from women to rule out any malignancies then cauterization to control the bleeding from the biopsy sites. It is a very invasive procedure for women but for the most part of it, women think of it as an invasion to privacy for someone to poke inside of them. My heart goes out for all my patients who underwent these procedures but i salute them for being courageous enough to deal with a problem that some women might just be too shy to tackle with. Indeed, education and reinforcement on serious issues like these should be openly discussed so more women will be aware of these medical problems and procedures.
ReplyDeleteThanks for your insight nyfreebird62, you were lucky enough to work and helped these women. I agree that women needs to be educated about this matter especially that this is more like a private thing for them.
ReplyDeleteMy biopy was done 5 months ago and I am still having stinging pain from the sight...nerve damage I would guess...the results showed NOTHING...Try every angle necessary before going through this procedure...
ReplyDeleteI, too, have that stinging pain 6 months from the vulvar biopsy...I am presently having pelvic floor physio-therapy to learn how to live with this pain....the biopsy showed nothing and now I am left with this constant sting...Horrible
DeleteI had mine 10 days ago. I have silver nitrate on it and it has burned the tissue opposite the biopsy site. Im in a lot of pain and can barely touch myself to clean the site. The silver nitrate is oozing since it is impossible to keep dry and when I tried to go without the ointment on the opposite side from the site I cracked and bled where it is burnt. With the pain, bleeding, burning, swelling and messy from the ointment I feel like I'll never heal. I hurt so much. It sounds like I may be right about never healing.
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DeleteJudy, I just had one on Thursday and they also put silver nitrate on it and it burned like hell when the numbness wore off (that did not numb enough that I felt them doing the biopsy!!!) I am having the problem of having a LOT of pain and also swelling, feels like razor blades when I try to wipe and I can't find one picture to show me what the *site* should actually look like...I called into the doctors (it's sunday) and the oncall doctor just said to wait until tomorrow to call into the office...no help at all, even though I'm telling her I am in a lot of pain and swollen and the Neosporin ain't helping one bit, I have started using a squirt bottle to rinse when I pee (like you do when you have a baby) to help with possible infection because that has me scared, that doctor on the phone told me to stop using soap in the shower and just use water (maybe the soap was bothering the biopsy site)..I've decided she's an idiot and will certainly tell my doctor the advice she gave...anyway I know yours was a year ago but since you did have the silver nitrate also, how long did it take to heal and did you swell? I really wish he would have put stitches in instead of the silver nitrate..
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ReplyDeleteIt took me well over a month to stop hurting. I was red and swollen and I went to the dr. after 2 weeks (because they never even scheduled a follow up) for the pain and she removed a big ugly black clot of the nitrate. It was extremely painful and burned like hell. She also gave me a stronger antibiotic than Neosporin and since it was infected an oral antibiotic.. I was also told not to use soap. Once the ugly clot was gone I could actually start to heal and then the swelling decreased but the pain continued until the hole started to close. Pat yourself dry and make sure that no urine is not left on the skin. The water you are using should help and reapply the Neosporin. I used a hand mirror so I could apply the ointment exactly where I needed it and squish it into the hole. They do not suture because it is a hole and holes need to drain to heal from the inside out. The area remained red for a long time but eventually it began to look normal. As long as you see any improvement you will be ok, its just like having a baby, you forget in time.
ReplyDeleteI recently had a vulvar biopsy done and four days after the procedure the wound is open and dark green and red. I called my obgyn and I was told to go to the emergency room if I’m that concerned well they looked and I do have an infection. I just cannot believe this and I feel like my life will never go back to normal
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