Vulval lesions are abnormal growths or sores on the vulva, the external female genitalia. These lesions can vary in appearance and cause a range of symptoms, from mild discomfort to severe pain. Vulval lesions can be caused by infections, inflammation, or even malignancies. Some lesions may be benign, while others may be precancerous or cancerous.

Vulval lesion excision refers to the surgical removal of these lesions. The excision procedure is typically performed to obtain a biopsy, treat benign growths, or remove malignant lesions. The goal of vulval lesion excision is not only to remove the abnormal tissue but also to preserve the surrounding healthy tissue to maintain the integrity of the vulva and prevent complications.

Vulval lesions can arise due to various factors, including infections, trauma, and inflammatory conditions. In cases of suspected cancer, an excision may also be performed to eliminate malignant tissue and prevent further spread of the disease.

This article will explore the causes, symptoms, diagnosis, and treatment options for vulval lesions. It will also discuss the excision procedure, prevention strategies, and potential complications, providing a comprehensive overview of vulval lesion excision for patients and healthcare providers alike.

Vulval lesions can be caused by a wide range of factors, from infections and inflammatory conditions to cancers. The excision procedure is typically required when a lesion is either malignant or causes significant discomfort. Below are the most common causes and risk factors that may lead to vulval lesion excision.

Causes of Vulval Lesions:

1. Infections:
   Infections are one of the most common causes of vulval lesions. Bacterial, viral, and fungal infections can lead to the formation of lesions on the vulva. Some common infections include:

   • Human Papillomavirus (HPV): HPV is a sexually transmitted infection that can cause genital warts. Certain strains of HPV can lead to precancerous changes in the vulva, known as vulvar intraepithelial neoplasia (VIN).

   • Herpes Simplex Virus (HSV): HSV can cause painful blisters or sores on the vulva, commonly known as genital herpes.

   • Candida (Yeast Infections): Yeast infections can lead to itching, redness, and the formation of lesions or sores on the vulva.

   • Bacterial Infections: Bacterial infections like bacterial vaginosis or streptococcus can also cause vulval lesions.

2. Trauma or Injury:
   Any form of trauma or injury to the vulva, such as abrasions or cuts from sexual activity, tight clothing, or vigorous hygiene practices, can result in lesions. These lesions may become infected and require excision for proper healing.

3. Inflammatory Conditions:
   Conditions like lichen sclerosus and lichen planus are inflammatory skin disorders that can cause white, thin, or scarred lesions on the vulva. These conditions may require surgical intervention if the lesions cause pain or are resistant to medical treatment.

4. Cysts:
   Bartholin’s gland cysts are fluid-filled sacs that can form on either side of the vaginal opening. While these cysts are usually benign, they can become infected and lead to the formation of abscesses. In some cases, excision is required to prevent recurrence or to drain the cyst.

5. Cancerous Lesions:
   Vulval cancer, though rare, can cause lesions that appear as lumps, sores, or ulcers on the vulva. The excision of these lesions is essential for diagnosis and treatment. Squamous cell carcinoma is the most common type of vulvar cancer.

6. Precancerous Conditions:
   Vulvar intraepithelial neoplasia (VIN) is a precancerous condition caused by HPV infection. VIN can cause changes in the skin of the vulva, leading to lesions that may need to be removed to prevent the development of full-blown vulvar cancer.

Risk Factors for Vulval Lesions:

1. HPV Infection:
   HPV infection is one of the strongest risk factors for developing vulval lesions, particularly those that can become precancerous or cancerous.

2. Chronic Inflammation or Skin Disorders:
   Chronic conditions like lichen sclerosus and lichen planus increase the risk of developing lesions that may require excision. These conditions can lead to scarring and discomfort in the vulval area.

3. Weakened Immune System:
   Women with weakened immune systems, such as those with HIV/AIDS, undergoing chemotherapy, or on immunosuppressive medications, are at higher risk for developing infections and cancers, including vulval lesions.

4. Age:
   Older women, particularly those over 60, are more likely to develop vulval lesions due to the decreased efficiency of the immune system and changes in hormonal levels during menopause.

5. History of Genital Warts or Cervical Cancer:
   A history of genital warts, cervical cancer, or other HPV-related conditions may increase the likelihood of developing vulval lesions.

Vulval lesions may be asymptomatic or may cause a variety of symptoms. The presentation of symptoms will depend on the cause and size of the lesion. Common signs and symptoms of vulval lesions include:

1. Visible Growths:

One of the most common signs of a vulval lesion is the appearance of abnormal growths or bumps on the vulva. These growths may vary in size, shape, and color and may appear as flat or raised, with a smooth or cauliflower-like texture.

2. Pain and Discomfort:

Many women experience pain or discomfort around the affected area. This pain can range from mild irritation to sharp, persistent pain. The pain may worsen with sexual activity, urination, or walking, especially if the lesion is inflamed or infected.

3. Itching and Redness:

Itching and redness around the vulval lesion are common, particularly if the lesion is associated with an infection, such as a yeast infection or herpes. Itching may worsen if the lesion becomes irritated or inflamed.

4. Bleeding or Discharge:

Vulval lesions may cause bleeding, particularly if the lesion is traumatized or infected. Abnormal vaginal discharge may also occur, often in association with an infection like bacterial vaginosis or herpes.

5. Swelling:

Swelling or tenderness in the vulval area may occur, especially if the lesion becomes infected or inflamed. The surrounding tissues may appear red and warm to the touch.

6. Ulcers or Sores:

Some vulval lesions, particularly those caused by infections like genital herpes, may present as open sores or ulcers. These sores can be painful and may ooze fluid.

Diagnosing the cause of a vulval lesion is crucial in determining whether excision is necessary. The diagnostic process typically involves a thorough medical history, physical examination, and potentially additional tests.

1. Physical Examination:

A detailed pelvic exam is the first step in diagnosing vulval lesions. The healthcare provider will visually inspect the vulva and surrounding areas for signs of lesions. The texture, size, and appearance of the lesion will help the provider determine the cause.

2. Biopsy:

In some cases, a biopsy may be performed to obtain a sample of the lesion tissue for laboratory analysis. A biopsy is necessary to determine if the lesion is cancerous or precancerous.

3. HPV Testing:

If there is suspicion of an HPV-related lesion, HPV testing may be done. This is particularly important if the lesion appears suspicious or is associated with other HPV-related conditions such as genital warts or precancerous changes in the cervix.

4. Blood Tests:

Blood tests may be used to check for signs of systemic infection or assess the immune system’s function. For instance, HIV or other immune-compromising conditions may increase the risk of developing vulval lesions.

5. Colposcopy:

If the lesion is near the cervix or suspected of being caused by HPV, a colposcopy may be performed. This procedure uses a special magnifying instrument to examine the cervix, vagina, and vulva for abnormal cell changes.

The treatment for vulval lesions largely depends on the cause of the lesion. Here are the main treatment options for vulval lesions, including excision:

1. Topical Treatments:

• Topical Medications: For non-cancerous lesions like genital warts, topical medications such as imiquimod (Aldara) or podophyllin may be applied to help shrink or remove the warts.

• Antiviral Creams: For lesions caused by herpes simplex virus, antiviral creams (like acyclovir) may be used to treat the lesion and prevent further outbreaks.

2. Excision of the Lesion:

Vulval lesion excision is the most common treatment for suspicious or problematic lesions. This procedure involves the surgical removal of the lesion, either through a small incision or by cutting out the abnormal tissue. Excision is performed under local anesthesia, and the tissue is sent for biopsy to determine if further treatment is necessary.

3. Cryotherapy (Freezing):

Cryotherapy involves freezing the lesion with liquid nitrogen to destroy the abnormal tissue. This treatment is commonly used for warts or other non-cancerous lesions.

4. Laser Treatment:

For larger or more extensive lesions, laser treatment may be used to vaporize the lesion. This technique is often used for HPV-related lesions that are difficult to treat with other methods.

5. Surgical Removal:

For larger or cancerous lesions, surgical excision may be necessary. This may involve the removal of a larger portion of the vulva, depending on the extent of the lesion. In cases of vulvar cancer, more extensive surgery, such as vulvectomy, may be required.

6. Post-Excision Care:

After excision, proper wound care is essential to promote healing and prevent infection. This may include keeping the area clean, avoiding sexual activity for a period of time, and using prescribed medications to manage pain or prevent infection.

Preventing vulval lesions involves addressing the risk factors and taking steps to reduce the chances of developing the conditions that cause lesions.

1. HPV Vaccination:

The HPV vaccine is one of the most effective ways to prevent genital warts and other HPV-related lesions. Vaccination is recommended for both boys and girls before sexual activity begins.

2. Safe Sexual Practices:

Using condoms during sexual intercourse can reduce the risk of HPV transmission and other STIs that can cause vulval lesions. Limiting the number of sexual partners also reduces the likelihood of contracting HPV.

3. Regular Gynecological Checkups:

Routine gynecological exams, including Pap smears and HPV testing, can help detect early signs of vulval or cervical changes, allowing for early intervention and treatment.

Though vulval lesion excision is generally a safe procedure, there are some potential complications:

1. Infection:
   Any surgical procedure carries a risk of infection. Proper care is essential to avoid infections at the excision site.

2. Scarring:
   Excision of vulval lesions may result in scarring, which can affect the appearance and function of the vulva.

3. Recurrence of Lesions:
   In some cases, vulval lesions may recur after excision, particularly if the underlying cause, such as an HPV infection, is not properly managed.

4. Pain and Discomfort:
   Post-operative pain and discomfort are common after vulval lesion excision, especially during sexual intercourse or physical activity.

Living with the results of vulval lesion excision requires patience and proper care:

1. Post-Surgical Recovery:
   Following excision, women should follow their healthcare provider’s instructions for post-surgical care, including wound care, avoiding sexual activity, and taking prescribed medications for pain or infection.

2. Psychological Support:
   The presence of vulval lesions can cause emotional distress, especially if they affect appearance or sexual function. Counseling or support groups may help women cope with these emotional challenges.

3. Sexual Health and Comfort:
   After healing, women may experience enhanced comfort and sexual function. However, it’s important to maintain open communication with a partner and to use lubrication if necessary.

4. Monitoring for Recurrence:
   Women who have had vulval lesions removed should have regular follow-up appointments with their healthcare provider to monitor for any recurrence or new lesions.

1. What is vulval lesion excision?

Vulval lesion excision is a surgical procedure in which abnormal growths, lesions, or tumors on the vulva (the external female genitalia) are removed. These lesions could be benign (non-cancerous) or potentially precancerous, and the procedure aims to excise the lesion while preserving the healthy surrounding tissue.

2. What causes vulval lesions?

Vulval lesions can be caused by various factors, including:

• Infections (such as HPV or herpes)

• Skin conditions (like eczema, lichen sclerosus, or psoriasis)

• Trauma or injury

• Benign growths (like cysts or warts)

• Cancerous or precancerous conditions, such as vulvar intraepithelial neoplasia (VIN) or vulvar cancer

3. How is vulval lesion excision performed?

The procedure is usually performed under local anesthesia, although general anesthesia may be used for more extensive excisions. The surgeon carefully removes the lesion or growth from the vulva, ensuring clear margins to reduce the risk of recurrence. Sutures may be used to close the wound, and in some cases, the tissue may be sent for a biopsy to check for signs of cancer.

4. Is vulval lesion excision a painful procedure?

Most patients experience minimal discomfort during the procedure due to local anesthesia. After the surgery, some pain or discomfort may occur as the anesthesia wears off. Pain management, including prescribed medications, can help alleviate any post-operative discomfort.

5. What is the recovery time after vulval lesion excision?

Recovery time varies depending on the size and location of the excision, but generally, patients can return to normal activities within 1-2 weeks. Sexual activity, vigorous exercise, and tampon use should be avoided for about 4-6 weeks to allow proper healing.

6. Are there any risks associated with vulval lesion excision?

As with any surgical procedure, vulval lesion excision carries some risks, including:

• Infection at the surgical site

• Bleeding or hematoma formation

• Scarring

• Nerve damage leading to altered sensation

• Recurrence of the lesion if not completely removed
  Your healthcare provider will discuss these risks with you prior to the procedure.

7. Will vulval lesion excision affect my ability to have children or my sexual health?

In most cases, vulval lesion excision does not affect fertility or sexual function. However, depending on the size and location of the excision, there may be some temporary changes in sensation or discomfort during sexual activity while healing. It’s important to follow your surgeon’s post-operative care instructions to ensure optimal recovery.

8. How can I prepare for vulval lesion excision?

Preparation typically involves:

• A pre-surgical consultation to discuss your medical history and the procedure

• Avoiding certain medications, such as blood thinners, before surgery

• Arranging for someone to take you home after the procedure if you receive general anesthesia
  Your doctor will provide detailed instructions specific to your situation.

9. Will the excised tissue be tested for cancer?

Yes, the excised tissue is usually sent to a laboratory for histopathological examination. This helps determine whether the lesion is benign or if it shows signs of precancerous or cancerous changes. The results will guide your healthcare provider in recommending any further treatment or monitoring.

10. Can vulval lesions recur after excision?

While vulval lesion excision is generally effective in removing the growth, there is a possibility that lesions may recur, especially if they were cancerous or precancerous. Regular follow-up appointments and check-ups with your healthcare provider are essential for monitoring your recovery and detecting any recurrence early.

The other Gynecology Procedures are:

• Cervical Polyps
• Hysterectomy
• Dilation And Curettage...etc

Few Major Hospitals for Vulval Lesion Excision are:

• Wockhardt Hospitals
• Apollo Hospitals
• Max Healthcare
• Piyavate Hospital
• Florence Nightingale Hospital

Thailand, Malaysia, Singapore, Turkey and India are the most cost effective locations that offer up to almost 80% savings in comparison to the US.

SurgeryPlanet facilitates a plethora of services to the medical treatment traveler also which includes, a hassle free and discounted travel option, a welcome hand at the airport on arrival, travel in an air-conditioned car, round the clock service & support. Your medical evaluation is pre arranged with the least of waiting time. Once your assessment is complete and found medically fit, the procedure is immediately scheduled without a waiting period. Please read through our Services and Testimonials to understand and select your best options.

• Thailand
• Malaysia
• Singapore
• Turkey
• India

Major Treatments Abroad: Obesity / Bariatric Surgery | Spine Surgery | Stem Cell therapy | Fertility treatment | Knee replacement in India and Thailand | Heart Surgery | Organ transplant | Ayurveda Treatment | Heart valve replacement | Hip resurfacing | Hospitals in India and Thailand for Laparoscopic Sterilization| Best hospitals in Asia | JCI & ISO certified Hospitals | Cost effective medical procedures | Healthcare tourism | Complete privacy for affordable cost | Weight loss procedures | Infertility treatment | Board certified physicians | Low cost surgeries