The vulva is rich in blood vessels and has loose tissue. If the epithelium remains intact but the subcutaneous blood vessels rupture, blood can rapidly spread through the loose tissue, leading to the formation of a hematoma in the vulva or even the vagina. Blood serves as an excellent medium for bacterial growth, and inadequate treatment can result in secondary infections.

bubble_chart Diagnosis

1. Vulvar hematomas mostly occur during trauma, childbirth, and first sexual intercourse. Generally, trauma results from accidental falls or collisions, where the vulva suddenly comes into contact with hard, angular objects. If the object is sharp, it may injure the vagina, bladder, rectum, or even the abdominal cavity.
2. In addition to feeling a lump in the vulvar area, patients also experience severe pain and difficulty moving. When a large hematoma compresses the urethra, urinary retention may occur.
3. Examination of the vulva or vagina reveals a blue-purple raised lump with significant tenderness.

bubble_chart Treatment Measures

1. If the hematoma is small, with a diameter of 4–5 cm, and the bleeding has stopped, local cold compresses can be applied, and close observation is necessary. If it does not continue to enlarge, warm compresses should be applied after 24 hours to promote hematoma absorption. Additional physical therapies such as ultrashort wave or infrared radiation may also be used.
2. If the hematoma is large or continues to enlarge, surgical incision should be performed to remove the blood clot, locate the bleeding point, and ligate it to stop the bleeding. If no active bleeding is found, after clearing the accumulated blood, the hematoma cavity can be closed with catgut sutures, and a drainage strip should be placed. If the hematoma is old or has become infected and suppurated, incision and drainage should be performed, with the drainage strip generally removed 24 hours postoperatively.
3. For vulvar hematomas, whether incised or not, treatment with Chinese medicinals can be combined after bleeding stops, such as oral administration of Seven-Li-Weight Powder or topical application of Seven-Li-Weight Powder. Methods like warm compresses, sitz baths, or physical therapy can also help absorb the hematoma. If infection has occurred, heat-clearing and detoxicating medicinals such as Lonicera or Dandelion can be added to the topical medication. Antibiotics should be used if necessary.