Vulva Special Anatomical Variations

Special anatomical variations

a. Sebaceous hyperplasia: It is not uncommon to have numerous, small yellowish papules along the inner aspects of the labia minora. These are harmless but slightly oversized sebaceous glands.

b. Vulvar papillomatosis: At the central margin of the vaginal vestibule one may see little frond-like or filiform projections. They are soft and completely asymptomatic. They can look like warts but warts are firm; these are soft.

c. Hymen types: A number of hymen patterns can be seen. The commonest are crescentic or annular but there may be several microperforations (giving a cribriform picture) or the hymen may be imperforate leading to primary amenorrhea with pain and bloating from trapped vaginal contents.

d. Labia hypertrophy: Hypertrophy of one or both of the labia minora is not uncommon. This is an anatomical variation. It is noted at puberty. Rarely it can occur due to chronic labial swelling due to lymphatic stasis or chronic physical pulling on the labia. The patients are usually asymptomatic but at times this can be a nuisance for hygiene, physical activity or sexual intercourse. If there is a problem, surgical reduction can be considered.