Surgical intervention may be appropriate and necessary for a few conditions in the vulvar area that are associated with vulvitis:
- Condylomata acuminata (synonyms: genital warts, wet warts, genital warts): surgical ablation of the skin lesions is usually the last therapeutic option after other therapeutic options (e.g., topical application of imiquimod or destructive solutions or ointments such as 5-fluorouracil, podophyllotoxin, trichloroacetic acid, silver nitrate) have been exhausted. In surgical therapy are used, the sharp spoon, the electric snare, the CO2 laser and cryosurgery. Alternatively, photodynamic therapy (PDT) 5-aminolevulinic acid is used.
- Bartholinic cyst/Bartholinitis abscess (pseudoabscess): the bulging cyst is incised so that the secretion empties. The cyst bellows is then sutured to the skin, so-called marsupialization. This serves the recurrence prophylaxis (measures to prevent a recurrence of disease) and at the same time to preserve the secretory function of the gland.
- Skin abscesses, boils, carbuncles: if an abscess cavity is present, it should be drained with the stab incision (surgical opening by means of a small incision).
- Bowen’s disease (precancerous): in Bowen’s disease, the affected skin site must be excised in healthy.
- Vulvar Vestibulitis Syndrome (VVS; synonyms: Burning Vulva, Painful Vulva, Vestibulodynia, Vestibulitis, Vulvodynia, Vestibulitis Syndrome, Vestibulitis Vulvae Syndrome): If the disease becomes chronic, i.e., the symptoms persist for more than six months, the extirpation (surgical removal) of the affected districts the so-called vestibulectomy or vestibuloplasty is recommended as ultima ratio therapy (“last resort”).
