Having a vulval lesion investigated
Your specialist has recommended that you have a vulval lesion investigated, which usually involves a biopsy – taking a sample of tissue for testing in the laboratory. This factsheet provides some standard information and advice about the procedure. However, you should always follow the instructions of your own specialist.
If you have any unanswered questions or concerns, please do not hesitate to ask your specialist or nurse for more information. It is natural to feel anxious, but often knowing what to expect can help.
What is a vulval lesion biopsy?
This is a minor operation to check the nature of one or more small lumps (lesions) on your vulva. The lesion, or a section of it, is removed and then tested in a laboratory to check if it is harmless or if cancer may be present.
The vulva includes all the visible sex organs in women. There are two outer lips (the labia majora) which are covered in pubic hair, two thinner inner lips (the labia minora) and the clitoris, at the front of the vulva. A vulval lesion may be anywhere in this area. You may be able to see it, or have symptoms including itching, discharge, redness, and pain during sex.
The operation is normally carried out as a day case, requiring no overnight stay in hospital. It is usually performed under a general anaesthetic, when you are asleep throughout, but if the lesion is very small you can be given a local anaesthetic. You will feel no pain in either case. For more details on anaesthesia, please see the separate BUPA leaflets.
Preparing for your operation
Your specialist or hospital will give you some information about when and how to check into hospital.
Before you come into hospital, you may also be asked to:
- Have a bath or shower at home on the day of your admission
- Remove any make-up, nail varnish and bulky or sharp jewellery. Rings and earrings that youd prefer not to remove can usually be covered with adhesive tape
- Follow the fasting instructions in your admission confirmation letter. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand
When you arrive at the hospital, your nurse will explain how you will be cared for during your treatment and will perform some simple tests such as checking your pulse and blood pressure.
Your specialist and anaesthetist will also visit you. This is a good time to ask any outstanding questions about your treatment.
You will be given a consent form to sign. By doing this, you confirm that you understand what the procedure involves, including the benefits and risks, and give your permission for it to go ahead.
Please refer to for further information below regarding the possible side-effects and complications of this procedure. You need to know about these in order to give your informed consent.
About the operation
Once the anaesthetic has taken effect, your specialist removes the lesion, or a section of it, generally using a surgical knife (scalpel). Whether or not your specialist decides to remove the whole lesion depends on its size and shape – if it is quite large, for example, it is more likely that only a small section will be taken for testing. If your specialist decides to cut out the whole lesion, some normal skin may need to be removed as well, to make sure all of the lesion is gone.
The operation site is then stitched with dissolvable stitches. There should not be much bleeding and you will generally not need a dressing.
The removed lesion will be sent to the laboratory and analysed under a microscope.
Removing vulval lesions or taking a biopsy will last around 30 minutes, depending on how many lesions are to be removed and whether your specialist is cutting out the lesion completely.
After your operation
You will be taken from the operating theatre to the recovery room, where you will come round from a general anaesthetic under close supervision. After this, or immediately after the operation if you have a local anaesthetic, you will return to your room or the day care ward.
Back on the ward
Your nurse will help make you comfortable. He or she will assess the operation sites and, after a general anaesthetic, will monitor your blood pressure and pulse at regular intervals.
You will need to rest on your bed until the effects of the anaesthetic have passed. If you are sore, you may require oral painkillers. These can usually be taken every four to six hours. Please discuss pain relief with your nurse, specialist or anaesthetist.
When you feel ready, you can begin to drink and eat, starting with clear fluids such as water and apple juice.
If your operation has been planned as a day case, you will be able to go home once you have made a full recovery from the anaesthetic. However, you will need to arrange for someone to drive you home and then stay with you for the first 24 hours. If you stay overnight following your operation, you may leave your room the next morning.
Before you are discharged, the nurse will advise you about caring for surgical wounds and bathing. The nurse will also give you a contact telephone number for the hospital, in case you need to ask for any further advice, and will make an appointment for you to return in about a weeks time, to receive your test results.
After you return home
If you need them, continue taking painkillers as advised by the hospital. A general anaesthetic can temporarily affect your co-ordination and reasoning skills, so you should avoid driving, drinking alcohol, operating machinery, or signing legal documents for 24 hours afterwards.
You need to keep the wound as dry as possible to help the healing process. Showers are recommended rather than baths, but if you do have a bath, dont soak in it for a long time. Dab the area dry carefully afterwards, or use a cool hairdryer. Your stitches will gradually come away naturally.
It is best to wear cotton underwear and loose clothing (no tights, for example) and not to use talcum powder until your stitches have dissolved, which will be in a couple of weeks. Use sanitary towels rather than tampons when you have your next period.
You should be able to return to most normal activities and to work within a couple of days; more strenuous activities and sexual intercourse should wait until you feel comfortable.
What are the risks?
Vulva lesion removal and biopsy are commonly performed and generally safe surgical procedures. For most people, the benefits in terms of improved symptoms, or from having a clear diagnosis, are greater than the disadvantages. However, all surgery does carry some element of risk. This can be divided into the risk of side-effects and the risk of complications.
These are the unwanted but mostly temporary effects of a successful treatment. Examples include feeling sick as a result of the general anaesthetic. You will feel rather tender and uncomfortable for a few days. There may be some bleeding from the wound, but you should be able to stop this by applying pressure, using a gauze pad supplied by the hospital. If you cannot stop it, get in touch with the hospital.
This is when problems occur during or after the operation and most people are not affected. The possible complications of any surgery are excessive bleeding during or soon after the operation, infection, and an unexpected reaction to the anaesthetic.
The chance of complications depends on the exact type of operation you are having and other factors such as your general health. You should ask your specialist to explain how these risks apply to you.
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.