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Vulval Lesion Excision

 
 

What is it?

The skin on part of the opening of your vagina - the vulva  is causing a problem. There is a swelling or a raw patch which may be bleeding or itching. To find out what the cause is, you need to have some or all of the problem area taken away. The piece of tissue will be looked at under the microscope to give an answer. Often that is all that needs to be done. Sometimes more treatment is needed. 

The Operation

You will have a general anaesthetic, and be completely asleep during the operation. Alternatively, the operation can be done under local anaesthetic (by numbing the area with a local anaesthetic injection like when you go to the dentist). Although a few centres do this operation successfully under local anaesthetic, many carry out the procedure under general anaesthetic because this is a very sensitive area and you can sometimes feel rather uncomfortable during the procedure. A small cut is made around the area or around a part of it. The piece is taken away for examination. The cut is closed up with a few stitches.

The stitches melt away after a few days and do not need to be taken out. The operation takes about 20 minutes. You should be able to come into hospital on the day of the operation and go home the same day.

Any Alternatives

If you leave things as they are, the problem is unlikely to go away. It may get larger and be more difficult to treat. Lasers and X-rays will not be helpful before the tissue has been looked at under the microscope. Your best way forward is to have this little operation.

Before the operation

Stop smoking and get your weight down if you are overweight. (See Healthy Living). If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first day after the operation. Bring all your tablets and medicines with you to hospital. On the ward, you may be checked for past illnesses and may have special tests, to make sure that you are well prepared and you can have the operation as safely as possible. . Many hospitals now run special preadmission clinics, where you visit for an hour or two, a few weeks or so before the operation for these checks.

After - In Hospital

You will have a sanitary pad in place. The vulva will feel tender for a week or more afterwards. Take painkillers to ease the pain. Take baths three times a day to keep the vulva clean and to help healing. There may be slight bleeding from the vulva or vagina for the first three or four days. Only use external pads for this. You need to pass urine before you leave the ward. If you have any difficulty, tell the nurses. You can wash the wound area as soon as you wish. Soap and tap water are entirely adequate. Salted water is not necessary. You can bathe or shower as often as you wish. You will be able to drink within an hour or two of the operation as long as you are not feeling sick. The next day you should be able to manage small helpings of normal food. You should plan to leave hospital the day of your operation. A District Nurse may call on you at home as required. You will be able to stay in hospital longer, if you are not ready to go home the same day. You will be given an appointment to come to the clinic for a check up and for the results of the test about six weeks after the operation. The nurses will advise about sick notes, certificates etc. You should be able to return to a light job after about one week, and any heavy job within two weeks.

After - At Home

Go to bed and rest for a few hours. Wait until you have had a check-up at the clinic before having sex.

Possible Complications

This operation is a minor one. Complications are very rare. There is sometimes some bleeding after two weeks or so. This will settle down. There is also a very small chance of a minor infection of your wound which can be settled by taking antibiotics for a few days.

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