Name of the Procedure:

Destruction of lesion(s), vulva; simple. Common name(s): Vulvar lesion removal, Destruction of vulvar lesions.

Summary

This procedure involves the removal or destruction of abnormal growths or lesions on the vulva using methods like laser surgery, electrosurgery, cryosurgery, or chemosurgery. It is a minimally invasive procedure typically performed on an outpatient basis.

Purpose

The procedure addresses vulvar lesions, which could be benign, pre-cancerous, or cancerous growths on the vulva. The goal is to remove these lesions to prevent potential complications, relieve symptoms, and reduce the risk of malignancy.

Indications

• Persistent vulvar pain
• Itching or discomfort in the vulvar area
• Visible lesions that change in size, shape, or color
• Biopsy-confirmed pre-cancerous or cancerous lesions
• Patient discomfort or cosmetic concerns

Preparation

• Follow fasting instructions if sedation or anesthesia is planned.
• Adjust medications as advised, especially blood thinners.
• Undergo diagnostic tests such as a biopsy, if not already completed.
• Avoid using lotions, creams, or other products on the vulva before the procedure.

Procedure Description

1. The patient lies in a position similar to a gynecological exam.
2. The area is cleaned and prepared.
3. Local anesthesia is administered to numb the area.
4. The lesion is identified and removed or destroyed using one of the following methods:
   • Laser surgery: Uses concentrated light to vaporize the lesion.
   • Electrosurgery: Uses electric current to burn and remove the lesion.
   • Cryosurgery: Uses extreme cold to freeze and destroy abnormal tissue.
   • Chemosurgery: Applies chemicals to destroy the lesion.
5. The area is cleaned again and dressed if needed.

Duration

The procedure typically takes 15 to 30 minutes, depending on the number and size of lesions.

Setting

This procedure is usually performed in an outpatient clinic, surgical center, or hospital outpatient department.

Personnel

• Gynecologist or dermatologist
• Nurse or medical assistant
• Anesthesiologist (if sedation is required)

Risks and Complications

• Infection
• Bleeding
• Scarring
• Pain or discomfort
• Changes in skin pigmentation
• Rarely, recurrence of the lesion

Benefits

• Relief from symptoms like pain and itching
• Removal of potentially pre-cancerous or cancerous tissue
• Minimal invasiveness with quick recovery times
• Improved cosmetic appearance of the vulvar area

Recovery

• Keep the area clean and dry.
• Avoid sexual intercourse and use of tampons until fully healed.
• Follow prescribed pain management steps, if needed.
• Schedule follow-up appointments to monitor healing.
• Recovery typically takes 1 to 2 weeks.

Alternatives

• Monitoring the lesion with regular check-ups if it is benign.
• Topical treatments, such as creams or ointments.
• More invasive surgical removal if lesions are large or numerous.
• Each alternative comes with its own risks, benefits, and recovery times.

Patient Experience

During the procedure, the patient may feel some pressure or mild discomfort but should not feel pain due to local anesthesia. Post-procedure, there may be soreness, mild pain, or swelling, managed with prescribed pain relief methods. Most patients return to normal activities within a week or two.