Vulval punch biopsies: what is the experience of patients and do they alter management?

Abstract

A questionnaire was used to assess the use of vulval punch biopsies with regard to patient acceptance, complications and relevance to management in patients attending the Oxford vulval clinic over a period of 1 year. All were satisfied with the reasons given for the biopsy. The majority (70%) found the injection of the local anaesthetic to be the most painful part of the procedure. Only minimal bleeding continued after the biopsy in a third of patients and stopped spontaneously within a few hours. None of the patients had secondary infection or chronic ulceration. The most common diagnosis confirmed by biopsy at the Oxford vulval clinic was lichen sclerosus (LS) and the mean age of patients was 63·6 years. Although no malignancy was diagnosed in our patients, in view of potential for malignancy and the lack of significant side effects associated with the procedure, we would recommend that punch biopsies be performed if LS is suspected.