Surgical Treatment Options For Vulvar Pain

As your Vulva Pain Doctor will tell you: “Removing areas of vulval tenderness from women with vulval pain syndromes has been practised by surgeons over many years. The operations are carried out by gynaecologists who have the greatest experience” [1]. Having surgery does not however, appeal to everyone, & there are now many conventional and cutting-options available – all of which can be discussed when you consult a Vulva Pain Specialist

The Low-Down on Surgical Procedures

Vestibulectomy is the key procedure which is recommended for the management of vulval pain syndromes. It involves removing the tender skin within the vestibule (the area between the labia minora). The level of tissue removal is not fixed, and is decided according to the patient’s symptoms, and what the surgeon considers optimal.

In some cases, just isolated areas of skin are removed from the lower region of the vestibule; while in others (namely, women with extensive symptoms), larger areas of the vestibule can be taken away (up to the front of the vagina close to the urethra, the duct which enables urine to pass out of the body) [1].

A less common surgical operation comprises removal of the labial skin and the skin close to the back passage. Both this and the aforementioned procedures, are normally undertaken under general anaesthetic in a hospital surgery theatre. The time which is allocated can range from 10 to 40 minutes. Convenient dissolvable stitches are normally administered in order to cover the areas where the skin incisions were made. In some cases, the patient can leave hospital on the same day, whereas in other cases, they will have to stay in overnight. Recovery time can vary from 6 weeks to 3 months, and during that period, the patient can see their Vulva Pain Doctor, who will monitor their healing, and prescribe any necessary emollients and steroid creams; as well as suggest any options to prevent scar formation [1].

Am I a Suitable Candidate For Vulva Surgical Treatment?

Vulval pain syndromes cover two conditions, vestibulodynia (vulval vestibulitis) and dysaesthetic vulvodynia:

“Surgery may be appropriate for vestibulodynia (pain localised to the vestibule when the area is touched). This is the classic feature of vestibulodynia, & removal of this tender area of skin will make sense for some women, & will be successful. However, on the whole, vestibulodynia is managed medically [by experienced Vulva Pain Doctors], & very few choose to go for surgery”[1]


[1]. Vulva Pain Society (2023). “Surgery for vulval pain.”