Vulval biopsy and treatment of VIN

• To diagnose vulval intraepithelial neoplasia (VIN for short), the vulva is examined in a procedure called vulvoscopy. A special microscope called a colposcope is usually used. Vulvoscopy is a painless, out-patient procedure. You will be asked to lie on your back with your legs in supports.

• Dilute acetic acid may be painted onto your vulva to show up any abnormal cells. This is not painful, but may cause mild irritation.

• Samples of vulval tissue, called vulval biopsies, may be removed for examination in the laboratory. These are taken either after numbing the area with local anaesthetic, or under a general anaesthetic. Your doctor may take several small circular punch biopsies (tiny circular samples of skin), or remove a larger piece of tissue (called an excision biopsy). You will probably need a few stitches after an excision biopsy, and these will leave a small scar.

• If you have VIN, the abnormal cells may be removed, or sometimes destroyed using a laser. This is usually carried out under general anaesthetic. You will be given painkillers and possibly also a local anaesthetic jelly to use for a few days after treatment.

• After VIN has been diagnosed, you will require regular vulvoscopy. An alternative way of managing this condition is to remove only areas that appear to be progressing towards early cancer. This may save unnecessary surgery.