The vulva is the part of the female anatomy that surrounds the vaginal and bladder openings and consists mainly of four skin folds. Two skin folds on either side of the openings. The four folds are joint in front of the bladder opening to surround the clitoris.

The vulva is examined as part of the annual gynecological check up. If you discover any lumps or sores let it immediately be checked. Although relatively rare cancer does occur on the vulva.

We will discus the lumps and growths that frequently effect the vulva. We won't discuss the treatment in detail. It is very important that treatment should be decided in consultation with the managing medical practitioner. It depends on many factors and the final decision should be made after a discussion between doctor and patient.

Bartholin Cysts

A lump or swelling occurring at either side of the entrance to the vagina is most probably a Bartholin cyst. One of the most common lumps occurring on the vulva is a Bartholin cyst. It is a swelling that is caused by a blocked gland. The Bartolin glands are two large glades situated on either side of the vaginal openings. The are responsible for secreting lubricating fluid during sexual arousal. When one of these glans are block a lump develops at the entrance of vagina. If the contents became infected a Bartholin abscess can occur. This is very painful condition. Bartholin cysts and abscesses keep on recurring if not properly treated.

The treatment is surgical drainage . The best results are achieved through a drainage procedure known as marsupialization. Under certain conditions total removal of the effected gland might be necessary.

Sebaceous Cysts.

They occur anywhere on the vulva. Small lumps of variable size and are benign. They developed in blocked sebaceous glands (skin oil glands).

Genital Warts

The scientific name for this condition is "Condiloma accuminata". It is a benign growth caused by a virus (Human Papilloma virus) It is a contagious condition and can be sexually transmitted. They begin as small lesions and if not treated in the early stages they will multiply and enlarge. In advance cases the whole vulva may consists of warts disturbing the anatomy of the vulva and causing sexual dysfunction. They basically consist of skin folds that are formed by fast growing cells as explained in the next drawings.

The next drawing illustrates changes occurring in skin cells following papilloma virus contamination. The virus combines with the DNA in the cell and the nucleus changes.

The next drawing illustrates how the abnormal cells starts dividing at an increased rate and change the structure of the skin.

The next drawing shows how the fast growing cells causes skin folds to develop. Due to limit space the fast growing cells are pushed to the surface and skin folds develop. The cells do not infiltrate or invade the surrounding tissue and the resultant wart is a benign growth.

The next drawing gives an illustration of an established wart with many skin folds.

The diagnosis is confirmed via biospies and histology ( microscopic examintion of the tissue obtained during the biopsy).

Treatment Options

Different treatment options are available. The latest is applying an an antiviral ointment. Surgical removal, laser treatment, application of chemicals to destroy the wart tissue and application of antiviral ointments. The antiviral drug in the ointment infiltrate the wart tissue and immobilizes the papilloma viruses causing the warts.

The treatment option to be implemented should be decided in consultation with the treating medical practioner. Repeated treatments might be necessary for optimum results.

Malignant Growths of the Vulva (Cancer)

Vulvar cancer is not very common but early detection is very important.

Early cancer can appear in different forms. It may appear as small hard swellings, sores ( ulcers), depigmentated areas ( white skin patches) or hiperpigmentated ( dark patches). It can occur in the |Bartholins glands although very rarely.

Vulval inspection is part of the anual check up, but do not rely completely on that. Regular inspection ( mirror) for white or dark patches and feeling for lumps is important. Anything that alarms you should be futher investigated. Rather visit a doctor unnecesary than to late. Furtunately most of the lesions will turn out to be benign.

The next drawing shows the danger of cancer and why early detection is important. If it is compared with a wart, the cancer cells invardes the surrounding tissues and destroy the basement membrane to invade the deeper tissues and even the blood and lymph vessels. The ideal treatment will be removal or destruction of the cancer before the basement membrane is penetrated.


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