How to treat vulvar hematoma

Vulvar hematoma is a type of gynecological disease. It may be caused by a viral infection that causes inflammation, leading to swelling and bleeding. In this case, medical treatment should be sought promptly to prevent the infection from spreading to the internal vulva, which will increase the difficulty of treatment and may even cause other diseases, affecting the treatment effect. Paying attention to personal hygiene in daily life, changing and washing underwear frequently, and reducing the intake of irritating foods can better help prevention and treatment.

Disease classification

Obstetrics and Gynecology

Disease Overview

Vulvar and vaginal hematoma:

Disease Description

Vulvar and vaginal hematoma: The hematoma extends from the labia to the paravaginal tissue, often involving the perineum and ischiorectal fossa. Only local hematoma of the vulva can be seen with the naked eye.

Symptoms and signs

After delivery, if there is tearing pain or even heavy pain in the vulva or vagina, or difficulty urinating, rectal compression, and blood loss symptoms, you should check for hematoma.

Symptoms and signs

After delivery, if there is tearing pain or even heavy pain in the vulva or vagina, or difficulty urinating, rectal compression, and blood loss symptoms, you should check for hematoma.

Treatment options

After delivery, if there is tearing pain or even heavy pain in the vulva or vagina, or difficulty urinating, rectal compression and blood loss symptoms, check for hematoma and give the following treatment: ① Anti-shock, blood transfusion if necessary. ② If a small hematoma does not continue to grow, it can be allowed to absorb naturally. For a large hematoma, perform an incision, remove the blood clot, insert a double-gloved finger into the rectum, lift the bottom of the hematoma, and suture to stop the bleeding. If suturing is difficult, gauze strips can be used to fill the hematoma cavity, counter-packing can be performed in the vagina, and an indwelling urinary catheter can be placed. The gauze strip in the vagina was removed after 12 hours, and the gauze in the hematoma cavity was removed after 24 hours. ③Give antibiotics to prevent infection.

Vulvar hematoma surgery steps

1. If the hematoma is large and there may be urinary retention, catheterization should be performed first.

2. Make a longitudinal incision on the mucosal surface of the weakest and most protruding part of the hematoma wall, directly reaching the hematoma cavity.

3. Remove blood clots in the hematoma cavity. Use fingers or gauze to remove all blood clots and send them for bacterial culture. Irrigate the hematoma cavity with sterile cold saline.

4. To stop bleeding, carefully check whether there are active bleeding points in the cavity. If there are, suture and ligate with fine silk thread. If it is diffuse oozing and the bleeding points are not clear, place gelatin sponge or hemostatic powder, press with gauze for a while, and then suture and close the wound cavity, which can often achieve the purpose of hemostasis.

5. Suture the wound: After sufficient hemostasis, use No. 0 intestinal suture to make intermittent or purse-string sutures from the bottom of the hematoma cavity to close the hematoma cavity without leaving any gaps.

6. Suture the incision: trim the excess incision edges, align them, and use absorbable sutures for interrupted sutures.

7. Placement of drainage If the hematoma is large, or there is a small amount of bleeding, or there is suspected infection, place a rubber drainage strip directly to the bottom of the cavity when suturing the incision. If there is infection or suppuration, remove the blood clot, stop the bleeding fully, clean the hematoma cavity, and place a drainage without suturing.

Postoperative care

Postoperative treatment of vulvar hematoma:

1. Cover the sutured wound with sterile gauze, add cotton pads, and secure it with a T-belt.

2. Use antibiotics to prevent and treat infection, and give vitamin K and hemostatic drugs to promote hemostasis.

The rest are general postoperative treatments for vulvar surgery.