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 symptoms but 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.

During the Procedure

  1. Positioning: You lie on an examination chair 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 gynaecologist will explain:
    • Diagnosis (e.g., infection, inflammation, or pre-cancer).
    • Next steps (e.g., medication, further tests, or treatment).
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Frequently Asked Questions

Will it hurt?

The area is numbed, so discomfort is minimal. You may feel soreness afterward.

The biopsy site is small and heals into a faint mark (rarely noticeable).

Yes – no sedation is used.

Your gynaecologist will discuss treatment options (e.g., surgery, medical).

Avoid shaving for 2–3 days prior to reduce infection risk.

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