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Vulva and Introitus

Biopsy of the Vulva

Excision of Urethral Caruncle

Bartholin's Gland Cyst Marsupialization

Excision of Vulvar Skin, with Split-Thickness Skin Graft

Bartholin's Gland Excision

Vaginal Outlet
Stenosis Repair

Closure of Wide Local Excision of the Vulva

Wide Local Excision
of the Vulva, With Primary Closure or Z-plasty Flap

Alcohol Injection
of the Vulva

Cortisone Injection
of the Vulva

Merring Operation

Simple Vulvectomy

Excision of the
Vulva by the Loop Electrical Excision Procedure (LEEP)

Excision of
Vestibular Adenitis

Release of Labial Fusion

Hymenectomy

Excision Of Hypertrophied Clitoris

Cortisone Injection of the Vulva

In patients with chronic pruritus of the vulva, subcutaneous injection of the vulva with a fluorinated cortisone preparation will often relieve the patient and break the vicious cycle of itching, scratching, excoriation, and irritation of cutaneous nerves. Pruritus of the vulva is often associated with parakeratosis that does not allow steroid cream to penetrate the skin and reach the important subdermal area. The injection must cover the entire vulva. Particular attention must be given to those areas that the patient designates as especially troublesome.

Physiologic Changes. Pruritus of the vulva is eliminated. Cortisone reduces the inflammatory reaction and improves the vascular supply and thus improves the nutrition of the vulvar skin.

Points of Caution. Care must be exercised to inject the entire vulva and to avoid penetration of the perineal branches of the pudendal artery and vein.

Technique

With the patient under general or local anesthesia in the lithotomy position, the surgeon outlines the inflamed areas of the vulva.