Doctors perform vulvar biopsies to collect tissue samples for laboratory testing. They examine the cells for any abnormalities that might be malignant, or cancerous.

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Cancer can start in any cells in the body, and although it is very rare, it can begin in a person’s vulva. The Society of Gynecologic Oncology (SGO) says that vulvar cancers make up less than 1% of all female cancers in the United States each year.

The vulva is a general term that describes the external structures of female genitalia. It includes the outer and inner lips of the vagina, known as the labia, urethra, and vaginal opening.

The American Cancer Society (ACS) adds that most vulvar cancers start in the inner edges of the labia minora or majora.

This article explains what a vulvar biopsy is and what to expect from the procedure.

A gynecological chair that a person sits in during a biopsy of the vulvar -2Share on Pinterest
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Vulvar cancers start with precancerous cells. Doctors recommend biopsies when they suspect someone has abnormal cells that may be malignant.

They collect a small sample of tissues and examine the cells under a laboratory microscope. This can help them detect cancerous cells.

According to the ACS, doctors may perform either an excisional or punch biopsy.

If the affected area is small, doctors may recommend an excisional biopsy. During this procedure, they remove the whole area of abnormal cells. Some people need stitches afterward.

For larger areas, doctors use a punch biopsy. Using a round, sharp, hollow, needle-like device, they remove a small, cylindrical sample of tissue. They may take more than one sample from different parts of the affected area.

The ACS explains that a doctor may use a magnifying glass to locate the affected area. They wipe the person’s vulva with a dilute acetic acid solution, which makes abnormal cells turn white, making it easier to find the suspect areas.

The doctor then injects a local anesthetic into the affected area, so the person will not feel anything, and collects the sample. Some people may experience discomfort during the procedure or feel pressure from a punch biopsy.

The United Kingdom’s National Health Service (NHS) notes that the procedure takes around 30 minutes.

Most people do not need to make changes when preparing for a vulvar biopsy, but the healthcare team will explain if they have any special requirements.

A doctor may ask some people to trim their pubic hair if it is obscuring the affected area. For some people, a healthcare professional may do this before the procedure.

People may wish to arrange alternative transportation for their return home after the biopsy.

Most vulvar biopsies are simple procedures, and people recover quickly. However, they may experience discomfort and itching as the area heals.

After the biopsy, a person may find it beneficial to rest for at least a few hours. For the rest of the day, they should also avoid prolonged standing or heavy work.

It may be more comfortable to wear loose, cotton clothing after the procedure.

The NHS suggests the following practices during recovery:

Washing the area

It is important to keep the area clean and dry. To do this, a person should avoid using washcloths and sponges. Instead, they should use plain water to wash the area, and gently wipe it dry.

Although it is important to keep the area clean, people should avoid soaking in the bath for approximately 2–3 days after the procedure.

After emptying the bowels, it is important that a person wipes away from the vulva and rinses the area after going to the toilet.

Returning to usual activities

A person may find that the area is tender for a few days after the procedure. People should avoid vigorous exercise during this time.

If a person finds it comfortable to do so, they can resume sexual intercourse after 3–4 weeks.

According to the ACS, people may receive their biopsy results within a couple of days. However, if doctors removed larger samples, it could take longer.

The results of the biopsy show if the person has any precancerous or cancerous cells in the affected area. Doctors will explain the results in more detail.

The ACS adds that other illnesses share similar signs and symptoms with vulvar cancer, so if the results do not contain cancerous cells, doctors will investigate further.

Next steps

The next steps depend entirely on the biopsy results. If a person’s biopsy reveals precancerous cells, and their doctors removed all of it during an excision biopsy, they may recommend topical treatments.

The ACS explains that these include the chemotherapy medication, fluorouracil (5-FU), and an immunotherapy medication, imiquimod.

If the person’s results show cancerous cells, doctors may recommend more tests to see if cancer has spread to other areas of the body. These may include a cystoscopy to examine the bladder, and a proctoscopy to look at the rectum.

Biopsies are routine medical procedures but can lead to infections or bleeding.

A person should seek medical attention if they develop a fever, experience swelling, or are bleeding heavily.

The cost of a vulvar biopsy can vary depending on where a person goes for the procedure.

A person can get the procedure done in an ambulatory surgical center (ASC). This is a non-hospital facility for those who do not need more than 24 hours of care.

Medicare breaks down the cost of the procedure if a person gets the procedure performed at an ASC:

Total cost$116
Doctor’s fee$60
Facility fee$56
Medicare pays:$92
Person pays:$23

A person can also get this procedure performed in hospital outpatient departments:

Total cost$707
Doctor’s fee$60
Facility fee$647
Medicare pays$565
Person pays$141

It is important to note that Medicare bases these figures on national averages. The cost can vary based on a person’s insurance policy and location. It is important to note that Medicare bases these figures on national averages. The cost can vary based on a person’s insurance policy and location.

Medicare bases these prices on their 2022 payments and copayments.

The following are frequently asked questions about a vulvar biopsy.

Does it leave a scar?

There is a slight risk that a vulvar biopsy might leave a scar. This usually depends on how large of a sample the doctor collects and how deeply they have to cut into the vulva.

Is it painful?

Some people experience discomfort during a vulvar biopsy, but doctors use local anesthetics to make sure the whole area is numb.

What are the warning signs of vulvar cancer?

The SGO explains that many people do not experience any symptoms during the early stages of vulvar cancer. However, people may notice changes in the color of their skin, making it appear paler or darker than usual.

Other symptoms include itching, a burning sensation around the vulva, lumps, warts, sores, lesions, tender spots, and pelvic pain.

A person may experience pelvic pain when urinating or while being sexually intimate.

During a vulvar biopsy, doctors collect tissue samples from a female’s external genitalia. This includes both sets of labia, the clitoris, the urethra, and the vaginal opening.

Most vulvar biopsies take place in a doctor’s office and are fairly quick. The doctor will send the samples to a laboratory for examination.