A woman’s intimate health is extremely important to ensure a healthy sex life and overall satisfactory health. However, among the various types of care and exams, there is one with a peculiar name that raises questions about what it is: vulvoscopy.

What Is Vulvoscopy?

Vulvoscopy is an examination of the skin surface of the vulva, perineum, labia, and vaginal opening (the external visible part of the female genitalia). A special microscope called a colposcope is used to view the area. This device allows for a magnification of 10 to 40 times the normal size. The exam is performed at the medical office where the patient remains on the examination table. It is generally done to complement a Colposcopy, which is the exam used to visualize the cervix.

Why Is Magnification Important?

The obtained images are magnified, allowing the specialist to observe possible cellular changes in the vulva that are impossible to see with the naked eye. Vulvoscopy may be recommended if the patient presents:

Exam Indications

  • Pain in the vulva
  • Any visible abnormality, such as lesions or lighter skin
  • Pain in the vulva during sexual intercourse
  • Bleeding
  • Itching
  • Burning

How Is Vulvoscopy Performed

During vulvoscopy, reagents such as acetic acid, toluidine blue, or iodine solution are used so that the areas to be examined are easier to visualize. Vulvoscopy does not cause pain.

When Is the Exam Requested

This exam is especially recommended for women who have had some abnormality in their Pap smear or for those in whom, during the gynecological exam, some change such as vaginitis and vulvovaginitis was noticed. It is also indicated for women suspected of having HPV; in this case, a biopsy of the vulva is required.

What Is a Vulvoscopy With Biopsy?

If abnormal cells are detected during the exam, a small biopsy (tissue sample) is taken under local anesthesia to be examined for abnormal cells.

Preparation for Vulvoscopy

Before having a vulvoscopy, it is recommended:

  • Avoid any intimate contact 48 hours before the exam;
  • Do not be menstruating during the exam.
  • Do not introduce anything into the vagina, such as vaginal medications, creams, or tampons;

How the Procedure Is Done

Before the vulvoscopy is performed, the specialist doctor will briefly explain the procedure. A small portion of tissue is removed from the vulvar area. This sample is sent to the laboratory for examination, and if necessary, stitches may be placed in the area where the tissue was taken. The stitches will dissolve in about seven days. Vulvoscopy takes about 20 to 30 minutes and is performed under local anesthesia. After the procedure, the patient needs to stay in the recovery area for a while, where she is monitored until fully recovered.

Can There Be Any Complication or Risk?

As with any procedure, complications may occur. These may include bleeding and infection. It is advisable to keep the area clean and dry. If the patient notices any problem resulting from the procedure, the doctor should be consulted as soon as possible.

Is It a Painful Procedure?

Usually, the woman receives a local anesthetic before the procedure. Upon discharge, if any discomfort is felt after the procedure, pain relief medication may be used. h3>How Is Recovery?

It is advisable to rest for a few days and refrain from working or exercising. Bleeding or discharge may occur for up to a week. If the patient experiences heavy bleeding or notices that the discharge has an unpleasant odor, it is important to contact the doctor. Changing sanitary pads frequently will help prevent infection. Sexual intercourse should be avoided until the area is completely healed. A vulvoscopy will show if treatment is necessary. If treatment is needed, it is usually performed under local anesthesia at the clinic once the biopsy results are available. If the area is widespread or a treatment such as laser is needed, this is done under general anesthesia with the patient admitted to a hospital.

When Is Colposcopy Necessary?

Colposcopy is usually performed when abnormal cells have been found during a smear test. This generally means that small changes exist in the cells of the cervix and, in many cases, these small changes return to normal on their own. Sometimes, the changes become worse and can lead to cancer in the future.

Indications

Colposcopy may be recommended if the patient presents:

  • An abnormality identified on the cervix
  • Bleeding after sexual intercourse
  • Bleeding between cycles
  • Persistent vaginal discharge

How Is Colposcopy Performed?

Similar to a Pap smear, a speculum is inserted into the vagina so that the cervix can be seen, and then it is viewed using a colposcope. If abnormal cells are detected, a small tissue sample will be taken from the cervix (biopsy) and then examined under a microscope. If the abnormal cells go deeper into the cervix, a cone biopsy may be needed (i.e., where a larger, cone-shaped tissue sample is taken). A colposcopy will show whether treatment is needed. If treatment is necessary, it is usually carried out under local anesthesia at the clinic with diagnostic biopsies taken at the same time. See Also: Cervical Cancer – Clearing Up Doubts Photos: S. Kellam