After exploration, the cavity should be rinsed thoroughly. If a skin graft is needed, the gynecologic oncologist may do it. A correction was published in January for this title. Early disease may be cyclic, corresponding to the secretory activity of the apocrine glands during the progestational phase of the menstrual cycle. The Mering procedure may be employed if all other measures have failed to produce relief of symptoms. Doctors have also learned that, when cancer is found early, there's no need to remove so much surrounding healthy tissue. Long-term management of adult vulvar lichen sclerosus:
Although spontaneous regression has been reported, VIN should be considered a premalignant condition, as shown by a case series of New Zealand women with VIN 2.
Diagram of wide local excision for VIN and vulval cancer
Thus, incisions on the labia or lateral labial area should be parallel to the labial axis. Condylomata acuminata generally present as small and usually multifocal lesions. Excision of a Bartholin's duct cyst is reserved for cases that have persistently recurred despite other measures, or for cases involving women older than 40 in whom a rare carcinoma may be detected. This technique is preferred to direct excision for recurrent cysts to maintain the functioning gland and to avoid the somewhat extensive dissection in this highly vascular area, which can result in scarring and vulvar pain. The excision should include a margin of noninfected tissue and the underlying subcutaneous tissue without fascia. A skinning vulvectomy is not recommended in Paget's disease, as these underlying areas of apocrine glands would not be adequately addressed. CO 2 laser vaporization, photodynamic therapy, excision and vulvectomy.