Traumatic vulvar hematomas: Conservative versus surgical management

Background. Vulvar hematomas are relatively uncommon and usually result fro m blunt trauma. They are more commonly diagnosed in postpartum patients, bu t hematomas after straddle-type injuries, coitus, or physical assault have been reported. Conservative and surgical management have both been advocate d as the appropriate initial treatment. Methods. In 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 surg ically managed groups. Results. Of the 29 cases reviewed, 19 were classified as obstetric and 10 w ere nonobstetric. All 13 obstetric hematomas and 3 of 7 nonobstetric hemato mas managed conservatively resolved without subsequent surgical interventio n. Conclusion. In the absence of acute hematoma expansion, conservative manage ment was often successful.