The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Grand Rounds

Traumatic Vulvar Hematomas Conservative Versus Surgical Management

Authors: ANTHONY M. PROPST MD, JOHN M. THORP JR. MD

Abstract

ABSTRACTBackgroundVulvar hematomas are relatively uncommon and usually result from blunt trauma. They are more commonly diagnosed in postpartum patients, but hematomas after straddle-type injuries, coitus, or physical assault have been reported. Conservative and surgical management have both been advocated as the appropriate initial treatment.MethodsIn this study, we have done a retrospective review to obtain data that might indicate a clinical benefit for either conservative or surgical management. We reviewed the charts of patients treated for vulvar hematomas at the University of North Carolina Hospitals between 1975 and 1991. Cases were separated into obstetric and nonobstetric and conservatively and surgically managed groups.ResultsOf the 29 cases reviewed, 19 were classified as obstetric and 10 were nonobstetric. All 13 obstetric hematomas and 3 of 7 nonobstetric hematomas managed conservatively resolved without subsequent surgical intervention.ConclusionIn the absence of acute hematoma expansion, conservative management was often successful.

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