Vulvoscopy

Vulvoscopy is a simple, outpatient examination of the vulva (external genitalia) using a special magnifying device called a colposcope. It helps identify abnormal areas that may require further testing or treatment. It is not a surgery and does not involve incisions.

Your gynaecologist may suggest this procedure if:

• You have persistent vulvar symptoms (itching, pain, burning, or visible changes).
• You have an abnormal cervical smear suggesting vulvar involvement.
• A suspicious lesion, discoloration, or lump is seen during a routine exam.
• You have a history of lichen sclerosus, HPV, or precancerous vulvar changes.

This procedure is not suitable if:

• You have severe vulvar inflammation or infection requiring treatment first.
• You are unable to tolerate the exam position (e.g., due to mobility issues).

Benefits

• Quick & non-invasive: Takes 10–20 minutes; no cuts or stitches.
• Accurate diagnosis: Detects early changes (e.g., HPV, precancer).
• Guides treatment: Directs biopsies or further management.

Risks and Complications

• Common:
  • Mild discomfort during the exam.
  • Spotting if a biopsy is taken.
• Rare:
  • Minor bleeding or infection (if a biopsy is performed).
  • Temporary tenderness.

Before Procedure

• Timing: Avoid during heavy menstruation (if comfortable).
• Hygiene: Shower normally; do not use creams, powders, or lubricants.
• Medications:
  • Take usual medications unless advised otherwise.
  • You may take pain relief (e.g., paracetamol) 1 hour before if anxious.
• What to bring: Wear loose clothing; sanitary pads (if biopsy planned).

During the Procedure

1. Position: You’ll lie on an exam table (like a cervical smear), with feet in supports.
2. Cleaning: The vulva is cleaned with a mild solution (may feel cool).
3. Examination:
   1. The colposcope (a lighted magnifier) is placed near the vulva (not inside the vagina).
   1. A vinegar (acetic acid) or iodine solution may be applied to highlight abnormal areas.
4. Biopsy (if needed):
   1. A tiny tissue sample is taken from any suspicious area (may feel a pinch).
   1. Local anaesthesia is used to numb the area first.
5. After: You can leave immediately (biopsy sites heal in 1–2 weeks).

Recovery

• Immediately after:
  • Mild stinging or spotting (if biopsied).
  • Use a pad for light bleeding (lasts 1–3 days).
• At home:
  • Avoid sex, tampons, baths, swimming, and strenuous exercise for 3–5 days.
  • Shower normally; pat the area dry gently.
• Discomfort relief:
  • Use over-the-counter painkillers (e.g., paracetamol).
  • Ice packs wrapped in a cloth can reduce swelling.

Results

• Biopsy results: Ready in 1–3 weeks (discussed in follow-up).
• No biopsy? Your doctor may explain findings right away.

Frequently Asked Questions

Q: Does Vulvoscopy hurt?
A: Most feel only mild discomfort. If a biopsy is taken, local anaesthesia minimizes pain.

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

Q: What if abnormal cells are found?
A: Treatment depends on the cause (e.g., creams for inflammation, minor surgery for precancer).

Q: Is Vulvoscopy related to cancer?
A: It helps detect early changes. Most women do not have cancer.

Q: Can I resume work the same day?
A: Yes – most return to normal activities immediately.

eGynaecologist Advice:

• You should seek gynaecological consultation if you develop heavy bleeding (soaking >1 pad/hour), fever (>38°C) or foul-smelling discharge) soon after the procedure is performed
• You should watch for any increasing redness or swelling (after 2 days) or severe pain not relieved by painkillers and contact your gynaecologist for further advice