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Dr. Andrew Rynne

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Had vulval intraepithelial neoplasia surgery. Getting loose flaps of skin. Squamous cell carcinoma?

Answered by
Dr. Aarti Abraham


Practicing since :1998

Answered : 6011 Questions

Posted on Wed, 9 Jan 2013 in Women's Health
Question: Hi, I had Vin surgery three years ago and after the surgery I noticed some loose flaps of skin in the back of my vagina towards my cervix which burn when rubbed over. I immediately brought it to the attention of my Gyn Dr. and he did a pelvic but could not feel it. But he never looked up there with a speculum. Now three years later my vagina is all swollen, so much so that I can't find the skin now and neither can the Drs. that have examined me. I asked my Dr. three years ago if it could be atrophy and he said yes and now I'm told that atrophy never shows up as loose skin. I have been doing some research and it sounds like squamous cell carcinoma. But the Drs. that have examined me say I don't have that although without a biopsy you can never be sure said one Dr. My symptoms are vaginal burning, discharge, severe swelling, aching and problems with urination and bowel movements. Also the growth that was there for three years would sometimes feel rough in one area. I just feel so stupid now for believing it was atrophy but my Dr. said it could be. So I just forgot about it and assumed it was. I should also say that this showed up in my vagina right after the Vin surgery and as part of the surgery they also did a vaginoscopy where they opened me up and smeared my vagina with acetic acid to check for any further disease and could not find anything. My Drs. just are convinced that I have nothing sinister in my vagina but now with the severe swelling in my vagina I can no longer feel the growth as it was for three years. But I can't find anything on the internet that describes lumps of skin growing up from the lining of your vagina that is except squamous cell carcinoma. I am just so scared that I don't know what to do because I know it was there for three years. But I just can't point it out to the Drs. now because it just isn't where it was before. What got me concerned about this is when my vagina started to swell up and I started having problems with urine retention and bowel movements I wentto my primary physician and she sent me in for a CT Scan which showed a growth on my liver which did turn out to be a Hemangioma but before I knew that you can only imagine how scared I was. Please do you know of anything this type of growth could be? Could I be swollen because of cancer gtowing and taking on a different formation? Please I would appreciate any and all recommendations. I just feel horrible.
Answered by Dr. Aarti Abraham 11 hours later

Thanks for your query. I went through the details submitted and I understand why you are so obviously worried and tense. Let me provide you with useful and helpful information.

Firstly, after VIN surgery, there might be some local inflammation and edema that makes the tissues swell up. This might feel as some tag or growth immediately after surgery. One would have known for sure only by a per speculum examination; it was unfortunate that your doctors did not perform a per speculum examination to confirm this.

Squamous cell carcinoma of the genital organs present as rapidly progressing growth with associated general illness. Your history does not typically represent that of a cancer, however without an opportunity to physically examine it is difficult to confirm / rule out this possibility. Therefore I would recommend consulting a gynecological oncologist, and go for a proper local examination including per speculum, per vaginum, if required a vaginoscopy, and most certainly a biopsy.

As you were, I am also glad to know the CT scan revealed hemagioma. It is not related to your current symptoms and nothing needs to be done for it as well, unless it is accompanied by pain over the liver area, which you don't have.

As for the rest of your symptoms, they do not point to anything specific, unless you have something specific coming up on your examination or biopsy. Any kind of cancer would come up on the biopsy, if your doctor would see something to take a biopsy from.
Plus, do not worry about the vaginal tags three years back, it could just be local tissue edema

Current burning, urine and bowel problems also could be because of the natural changes in the vaginal area after surgery - such as fibrosis, induration (thickening), etc.

Please calm down, and consult a gyne-oncologist whenever feasible.

Hope this was helpful. Feel free to ask for further clarifications, I will be glad to assist you.

Take care

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Aarti Abraham 6 hours later
The flaps of skin that I located in back of my vagina towards my cervix were first noticed by me three years ago right after my VIN surgery but have remained there. I was told by my OB/GYN that it was atrophy. But my Dr. couldn't feel it by doing a pelvic and he didn't try to look witb a speculum. But I know that the flaps of skin are still present in my vagina it is just so swollen in my vagina now that I cannot locate them. Therefore the Drs. can't see what I'm talking about. So my question is do you know of any benign growths that grow from the lining of your vagina and that are located in back of your vagina towards your cervix? I also now know that atrophy never appears as flaps of skin. Now also my Dr. is saying that atrophy does not appear as flaps of skin. Also would squamous cell carcinoma cause my vagina to swell up?
Thank You
Answered by Dr. Aarti Abraham 2 hours later

Once again, if those flaps of skin were there right now they would be definitely visible to a doctor; if not directly, then by speculum examination, and definitely by vaginoscopy. So, if a gyne-oncologist tells you after thorough examination that they are not there, then they aren’t.

Also, atrophy doesn’t present as flaps of skin. But hardening, fibrosis and induration of the vaginal tissue due to surgery or scar might feel as bits of skin.

Also, have you actually seen these flaps, or merely felt them on examination?

Squamous cell carcinoma technically speaking CAN cause vaginal swelling and hypertrophy; but please be assured that it is a diagnosis easily made by local excision biopsy.
So please proceed with that, to put your mind at rest.

Hope this clarifies your doubts. I will be glad to clarify other doubts that you may have.

Take care

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Aarti Abraham 2 hours later
Dr. XXXXXXX XXXXXXX no, I never saw the flaps of skin just felt them. The Drs. don't seem to want to do a biopsy because I can't find the flaps of skin due to all the swelling in my vagina now. The GYN Dr. I saw who was an oncologist said it could cause a fissure. So far I have seen my primary OB/GYN, the GYN Dr. specializing in oncology and a urogynecologist. They have all used a speculum to examine me but so far no one as used a colposcope or done a vaginoscopy. But I know the growth didn't just fly away and without being able to find it due to all the swelling it is very hard to have piece of mind. I'm just so scared I don't know what to do. My vagina doesn't feel anything like it use to it's like it is somebody elses vagina. There are big fatty balls of tissue up there that I have never felt in my life. Yet all the Drs. don't seem to notice any swelling. But they do admit that all vagina's are different. Mine is certainly not normal now. It stings, hurts and aches. Would you recommend I insist on a biopsy. So afraid it could be cancer. Thank You
Answered by Dr. Aarti Abraham 8 hours later
If all 3 doctors, including 2 specialists have examined you, I dont think we need to worry here.
Whatever amount of swelling in the vagina you might be currently having, such trained doctors cannot fail to see anything inside if it is still there.
Growths do not fly away, but as I told you, if it was post operative edema and scarring, it does resolve over time
If they didn't do a vaginoscopy or colposcopy, it was because they did not see any indication for it.
But I can see how the fear of it being a cancerous growth is consuming you, so yes, go ahead and insist on a biopsy
Take care.
Above answer was peer-reviewed by : Dr. Aparna Kohli

The User accepted the expert's answer

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