Evacuation of a large traumatic vulvar haematoma with an intravaginal cosmetic approach

Ghanshyam S Yadav1 and Amir Marashi2,3

Author affiliations

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA
Department of Obstetrics and Gynecology, New York Presbyterian Brooklyn Methodist Hospital, New York City, New York, USA
Obstetrics & Gynaecology, Professional Brooklyn Gynecological Services, New York City, New York, USA

Correspondence to

Dr Ghanshyam S Yadav, gyadav@bcm.edu


A healthy youngwoman presented 3 days after a jet ski accident with a large left vulvar haematoma measuring 12 cm. Immediately postinjury, she was managed conservatively in the emergency room of another hospital. However, the haematoma continued to slowly expand. She presented to our clinic with difficulty walking and severe discomfort. Decision was made to drain the haematoma surgically. The patient was sceptical to have scarring on her vulva. Thus, the haematoma was evacuated by a vertical incision on the left vaginal sidewall. After evacuation and achieving haemostasis, the was closed with two interrupted sutures. Edges of the incision were secured similar to marsupialisation with five interrupted sutures to allow continual drainage. Her discomfort resolved immediately postsurgery and she had an uncomplicated postoperative course. The intravaginal approach yielded superior aesthetic result with no scarring on the external vulva.