A haematoma is defined as the accumulation of blood caused by the rupture of blood vessels under the skin. When it occurs in the perineal or vulvar area, it is called a vulvar haematoma.
The most frequent causes are bruises or blows to the perineal area and sexual intercourse with penetration or insertion of foreign objects. It is favoured by coagulation disorders or by taking anticoagulants.
It manifests with pain, a lumpy area and dark red discolouration 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 amount of red blood cells and clotting factors.
Most vulvar haematomas are mild and resolve spontaneously. In more severe cases where bleeding is not self-limiting and/or is accompanied by a lot of pain, surgical evacuation of the haematoma may be necessary.
- Merritt DF. Vulvar and genital trauma in pediatric and adolescent gynecology. Curr Opin Obstet Gynecol 2004; 16:371.
- Okur H, Küçïkaydin M, Kazez A, et al. Genitourinary tract injuries in girls. Br J Urol 1996; 78:446.
- 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.
