Hematoma is defined as the accumulation of blood produced by the rupture of blood vessels under the skin. When it occurs in the perineal or vulvar area, it is called vulvar hematoma.
The most frequent causes are bruises or blows to the perineal area and sexual intercourse with penetration or insertion of foreign objects. It is favored by coagulation disorders or by taking anticoagulants.
It manifests with pain, a lumpy area and dark red coloration of the skin in the genital area.
Diagnosis is made by clinical examination revealing a history of trauma and genital examination. A blood test may be necessary to quantify the number of red blood cells and coagulation factors.
Most vulvar hematomas are mild and resolve spontaneously. In more severe cases where the bleeding is not self-limiting and/or is accompanied by a lot of pain, surgical evacuation of the hematoma may be necessary.
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- Patel BN, Hoefgen HR, Nour N, Merritt DF. Genital trauma. In: Pediatric & Adolescent Gynecology, 7th ed, Emans SJ, Laufer MR, DiVasta AD (Eds), Lippincott Williams & Wilkins, 2020. p.237.
