Vulvar Biopsy and Excision/Ablation

Abstract

The vulva, or female external genitalia, includes several structures. These include the paired labia majora and labia minora, the clitoris, the vulvar vestibule, the external urethral meatus, and the vaginal orifice. The vulvar vestibule includes the urethral and vaginal openings and the ducts of the Skene’s (paraurethral) glands and Bartholin’s (greater vestibular) glands. Several conditions can involve the vulva. These may be benign, premalignant, or malignant. Office evaluation and management of vulvar lesions, excluding cysts and abscesses of the Skene’s and Bartholin’s glands, is the focus of this chapter. Lesions involving the vulva may be visible on basic examination in the form of masses, ulcerations, or areas of altered pigmentation. Alternatively, some lesions may not be visible on gross examination and require colposcopic evaluation to be discovered.