All about vulval lesion excision

What’s involved in vulval lesion excision? Different patients have different reasons but one thing they all have in common are questions about exactly what happens. Leading consultant obstetrician and gynaecologist Mr Timothy Hookway speaks to Top Doctors to answer queries about this surgical removal procedure.

What exactly does a vulval lesion excision entail?

Vulval lesions are often a small area of abnormality on the vulval skin.

It may be:

• A small ulcer
• Area of irritation or inflammation

or;

• A skin tag

They can often be excised (removed) under local anaesthetic in an outpatient clinic, or in the operating theatre. 

The area is cleaned with an antiseptic solution, and then some local anaesthetic is injected through a tiny needle. The lesion can then be excised, either using a 'punch' biopsy, which is similar in size to a hole punch, or a small scalpel. A single (dissolvable) stitch is often required to stop any bleeding.

There may be a small amount of discharge following the procedure; it would be advisable to wear a pad and keep the area clean and dry for a few days.

What does it detect/remove and how effective is it?

They can be used to diagnose a suspicious lesion like cancer or precancerous cells, or to diagnose conditions such are lichen sclerosis which can cause significant irritation to the vulva. When lesions are removed in their entirety, then it is very effective. However, if a biopsy is taken then further excision may be required once the diagnosis has been confirmed.

Is it painful and how long does it last?

The procedure is often performed under local anaesthetic. It can be a little uncomfortable but not usually painful. It takes up to about 10 minutes.

Who is the ideal candidate for this procedure?

Anyone with a vulval lesion! If you are taking medication that affects your blood clotting, or have any allergies, it is important to let your doctor know. You may need to stop some medication prior to the procedure. 

What would you recommend patients to do before and after surgery?

Sometimes taking simple painkillers half an hour before an outpatient procedure can help. It is important not to shave or use hair removal products for a few days prior to the procedure. Afterwards, keeping the area clean and dry will assist in recovery.

If you’re looking for the best care regarding vulval lesion excision, make an appointment with Mr Hookway. Visit his Top Doctors profile here, to arrange today.