Making Vulvar Biopsy Less Painful

A small trial suggests applying topical anesthetic prior to biopsy may be better for the patient's comfort than injecting anesthetic.

Patients undergoing vulvar biopsy often report that preliminary injection of local anesthetic is the most painful part of this common gynecologic procedure. In a single-site U.S. trial, investigators randomized women with planned vulvar biopsy of a non–hair-bearing surface to topical lidocaine-prilocaine cream (EMLA) left in place for ≥10 minutes prior to biopsy or conventional injection of 1% lidocaine ≥1 minute before biopsy. The clinician could inject additional lidocaine regardless of treatment arm if deemed appropriate. Pain was participant-reported on a scale from 0 mm (no pain) to 100 mm (worst imaginable pain).

Among 37 participants (median age, 60; 57% white, 44% black), median pain scores at biopsy were 6.0 (lidocaine-prilocaine cr…

Reviewing Author

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Andrew M. Kaunitz, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportMerck, Mithra, Medicines360

Editorial BoardsContraception; Menopause; Contraceptive Technology Update; OBG Management; Medscape OB/GYN & Women’s Health

Making Vulvar Biopsy Less Painful

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Reviewing Author