Biopsy

Hi. Firstly, I am still quite astonished at how many queries there are, daily in relation to our 'mutual problem'. Hopefully, you will at least find some comfort in knowing just how many of us are posting on this site, despite not previously hearing anything about VIN, Vulva cancer, Lichen Sclerosus etc. You are certainly in good company. 

I am in the UK and have had two biopsies in 9 months, followed by a recent Wide Local Excision for VIN 3. The biopsy is actually quite straightforward and the anticipation is probably worse than the procedure. Female staff will be with you to look after you and another will give you an injection of local anaesthetic in the area where the biopsy is to be taken. This is the most painful part, likened to a short, sharp sting. After that, you will feel nothing, accept, at worse maybe a very slight tugging sensation. You will then, probably have one or two stitches, which I expect will be dissolvable, (so you won't have to go back again too soon later to have them removed). You will be advised to shower and not to bathe for a week or so after so the stitches do not dissolve too quickly. Urination can sometimes sting, at first and the area can also become quite itchy but try not to scratch and you need to keep the area clean to prevent infection. You should, however get provided with some literature or verbal information on how to deal with the healing process. I found long periods of sitting more uncomfortable than standing or walking, for a few days after so you may want to take this into consideration when thinking about work or general day-to-day life.

If there is anything, and I mean anything else you want to know, please don't be afraid to ask. We are all here for you and one another. (Listen to me!.. I have suffered with this problem for approximately 17 months and I sound like some sort of expert!.. once you have your biopsy you will have a much better idea on what to expect, should any future treatment be required and you will be an expert yourself). There really is no need to worry though, if I can deal with it, anyone can.

Best wishes.

Hi C. L

I just wanted to share that I've had a biopsy two weeks ago today and as mine was done under general I didn't feel anything but I can say aitch has given you some good advice for afterwards. Even at the weekend  11 days post biopsy) I was sitting on my kitchen chair and I found that as it was so hard I had lumps where my biopsy sites are so even though you'll feel fine after a few days still try and remember there is ongoing healing happening. I found the recovery OK, my stitches are still in tact but should dissolve fairly soon I think. My wounds were great when I first looked, I had some bruising but nothing too dramatic and everything is healing nicely. I shower every day, don't use anything to wash myself and I used hair dryer on cool setting to ensure I was dry. 

It does get very itchy after about a week, I was scared to put anything on but the itching became so intense that I put some cream on yesterday and it worked wonders, itching is my main symptom though so I can't say for certain it was the biopsy causing the itching. 

The waiting for results that is probably the worst, as I'm sure everyone on here agrees. The longer I wait the less anxious I become (surprisingly) but that is because I genuinely don't think mine is sinister. However, I have at various points diagnosed myself with every possible result I can think of and probably some new ones and been completely convinced that is what I have, keeping busy has kept me sane lol I don't know what your symptoms are but try and remember that a biopsy is to indicate a diagnosis and it may not be worst case scenario (although facing any issue down there isn't ideal!) 

The help and advice on here can be invaluable as there will always been someone who has been through what you're going through, if not worse and it does help when we have our little wobbles so you post away and ask as many questions as you want to and rant and rave if you feel the need to because we genuinely have been there and know how you feel, sometimes it's difficult for others to understand as most people don't even know what a bloody vulva is, never mind imagining getting a biopsy done on it, everyone just assumes you mean cervix lol

Anyway I hope you have a date for your biopsy and get it over you soon, and in the interim we're here 

L xxx

C.L.88, I know this can be so very scary to hear that you need a biopsy and you probably have never even heard the words VIN or Vulvar problems, heck most women don't even know all of their lady parts is what I've learned over the years. You don't know how many people have asked me why I didn't just have a hysterectomy. LOL 

The two ladies who have replied have given you great tips and personal experience that hopefully answers some of your questions. I hope it's alright if I add a few things myself?

I've had about 170+ vulvar biopsies over the past 12 years now. You will find that some of us give experiences that are different then others but that's because of the different doctors such as if you have a gynecologist, or a gynecology oncology surgeon, etc. Also, it depends on where you live, I live in the United States so I am going to give you some of my experiences:

1. You may hear the doctor say they are going to do a colposcopy prior to the biopsy. This procedure really doesn't hurt unless you have a condition like Lichen Sclerosis which can be like lesions or cuts because the solution they use to put on your skin (in the area or areas they will be biopsying) is made with vinegar and can sting. They look at you under a microscope lens and are looking for changes in skin to narrow down where they may biopsy. They also may be able to see the skin changes with naked eyes and then biopsy.

2. Next, like Aitch said, they will numb the area so you don't feel the biopsy. This numbing shot stings, if it's in your 'lips' area it hurts but is tolerable, but if it's near your urethra or on your urethra or by your clitoris it's pretty painful but doesn't last long. You will numb quickly and ready for the biopsy. Most doctors will do a punch biopsy which is a tool that will take a small chunk out of the area. It's about the size of a pencil eraser. It goes in, they twist and the tissue sample comes out. Some doctors clip an area instead of the punch.

3. Not all doctors suture the biopsy areas; I've had many that just left them open to heal and when you have 3-4 at one time it can be painful. If you can ask, I'd ask if they can stitch them because they heal so much quicker. I've also have them cauterized with silver nitrate. It doesn't hurt when they do it because you are still frozen at that point. 

4. you will need a pad in your underpants afterwards for some bleeding caused by the biopsies.

5. I was never told I couldn't shower or anything for biopsies so I'd ask the doctors. I would however request a squirt bottle, they are called a perineum bottle. It is very soothing to fill with luke warm or cool water to squirt while you are peeing in case your pee burns the area that was biopsied. Never wipe, you will want to pat dry then use a blowdryer on cool setting. 

6. Like one of the ladies said, she had hers under general anesthesia, this is usually saved if they will be doing more than 4-5 and/or if they need to go for a deeper biopsy; then they usually do put in stitches. You will still follow the tips of the squirt bottle and blow dryer though. 

7. If you have a donut, it's a blow up cushion type ring that you can find at a drug store for under $15 it will help in your car, or chairs.

Just remember, everyone heals differently. I am so used to biopsies, I used to go to work the next day if I had 1-3; I'd take three days off work if I had 4-5 and a week if I had more than 5 but that usually meant I went to the O.R. for that many. They usually don't try that many biopsies in the doctor's office.

Ice packs over your underwear or with a towel over the pack is very cooling and helps with the swelling and itching from healing. You will be just fine, you sound pretty strong to me; especially because you have found this place of amazing women. We are all here for support for you and each other. There are no dumb questions so please ask anything; the good thing about asking questions is there may be someone you are helping because they were too afraid to ask it.

One other thing, don't get too far ahead of yourself, you don't want to spend time worrying about something that may not be worthy of your energy and the concerns may be nothing more than putting your mind and the doctor's mind at ease.

Let us know when your biopsy is so we can pray for you and help you in any way we can!! We want to be a support system for you because sometimes the waiting game is worse than the procedure.
Take Care,

Lisa

Dear CL88, 

Its pretty daunting the prospect of a biopsy but if you havent already had it by now, you should know tbat the process despite being a worry is pretty quick and is made as painless as possible. 

You will have an injection to numb the area, but please ask before you go in for some lidocaine gel to rub on your skin ahead of the injection. It numbs the skin surface ahead of the injection which is good. I had it every time without asking.     

I had an initial diagnostic biopsy followed by 3 mapping biopsies ahead of my surgery. They were all a bit sore and a bit itchy afterwards.  

You'll get a dissolvable stitch and you'll just need to keep the area clean afterwards perhaps pouring clean warm water over after weeing then either cool hairdryer or dab with drywipes from the chemist. I wore a skirt and no knickers whilst i was at home to keep the area cool and aired which helped.

Best of luck, i hope you get it out of the way asap and tbat it brings a good outcome for you! Px

Hi ladies thank you for all the advise, I am finally heading for my biopsy tomorrow morning. I’m still anxious as to what to expect especially as I am now starting a new job tomorrow too which I have to go straight to after my appointment. Reading these comments has made me feel as though I should have asked to start at a later date? I will keep you all updated with the results. Thank you again x

Hi,  How are you ? I was interested to read your message here.

A couple of months ago I had itching and burning sensations down below. My Gp refered me to a Gynaecologist.

I have been had three biopsies and have Vin 1 & 3.  I am a 60 something and had never heard of this thing. I am really not sure what treatment to go for, the surgery or the imaquimod treatment. Any opinions?

Hello Private bits, 

Sorry to hear that you are faced with confusing decisions. 

I have never had the imiquamob so I cant advise from experience.

My first instinct would be, heck, try the cream, that is if you will still have option of surgery if it doesnt help.

I had some advanced vin removed but given it was mixed with cancer I wasnt faced with the added stress of choosing.

I suppose it also depends on how big an area is affected. If small maybe surgery and get it over with, if big area with prospect of big surgery then maybe try the imiqua cream first......

My very very best advice is to get back to your consultant and ask them for some clearer guidance and whether you can still opt for surgery later. Keep asking questions until you are clear what each option might mean. 

Best of luck, love lemoncake