Vulval Biopsy

A vulval biopsy is a minor procedure to remove a small sample of tissue from the vulva (the external genital area) for laboratory testing. It helps diagnose skin changes, infections, or abnormalities such as vulval cancer or pre-cancerous conditions.

This procedure is quick and safe – performed under local anaesthesia (numbing cream or injection) and helps determine the cause of symptomsbut is not a treatment.

Why is it Performed?

Your gynaecologist may recommend this biopsy if you have:

• Unexplained itching, pain, or sores on the vulva.
• Suspicious skin changes (e.g., thickened patches, discoloration, ulcers).
• Concerns about lichen sclerosus, vulval intraepithelial neoplasia (VIN), or cancer.
• Persistent rash or lesions not responding to treatment.

Before the Procedure

• Preparation:
  • Avoid blood-thinning medications (e.g., aspirin, ibuprofen) for 24–48 hours (ask your gynaecologist first).
  • Shower/wash the vulval area gently.
  • Wear loose, comfortable clothing.
• Inform your gynaecologist if:
  • You are pregnant or have allergies (e.g., to local anaesthetics).
  • You take anticoagulants or have a bleeding disorder.
• Optional: Ask for a female chaperone during the procedure.

During the Procedure

1. Positioning: You lie on an exam table with legs supported (similar to a smear test).
2. Cleaning: The vulval area is cleaned with an antiseptic.
3. Numbing: Local anaesthetic is applied (you may feel a brief sting).
4. Biopsy: A small tissue sample is taken using a scalpel or punch tool (takes 5–10 minutes).
5. Closure: Stitches may be used for larger samples (dissolvable or removed later).

What you might feel:

• Pressure or mild discomfort (no pain due to anaesthesia).
• Slight tugging during the biopsy.

Risks and Complications

• Common (temporary):
  • Mild pain, bruising, or swelling.
  • Light bleeding/spotting for 1–2 days.
• Rare but serious:
  • Infection (redness, warmth, pus, or fever).
  • Allergic reaction to anaesthetic (rash, itching).
  • Scarring or changes in skin sensation (rare).

Aftercare

• Wound care:
  • Keep the area clean and dry.
  • Use a sanitary pad (not tampons) if bleeding.
  • Avoid baths, swimming, or tight clothing for 3–5 days.
• Pain relief: Over-the-counter painkillers (e.g., paracetamol).
• Avoid: Sex, vigorous exercise, or scented products until healed (1–2 weeks).

Getting Results

• Results take 1–2 weeks. Your doctor will explain:
  • Diagnosis (e.g., infection, inflammation, or pre-cancer).
  • Next steps (e.g., medication, further tests, or treatment).

Frequently Asked Questions

Q: Will it hurt?
A: The area is numbed, so discomfort is minimal. You may feel soreness afterward.

Q: How big is the scar?
A: The biopsy site is small and heals into a faint mark (rarely noticeable).

Q: Can I drive home?
A: Yes – no sedation is used.

Q: What if the results show cancer?
A: Your doctor will discuss treatment options (e.g., surgery, radiotherapy).

Q: Can I shave the area before the biopsy?
A: Avoid shaving for 2–3 days prior to reduce infection risk.

eGynaecologist Advice:

• You should seek urgent gynaecological consultation if you notice heavy bleeding, raised temperature >38°C, or severe pelvic pain following the procedure