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Woman, 25, needed surgery on her vulva after she landed on her jet ski handlebars

A woman who landed directly on the wheel of her jet ski in a bizarre accident, was left with a swelling blood clot on her vulva that had to be surgically removed

In a case report, published in BMJ Case Reports, the 25-year-old arrived three days after the incident at Professional Brooklyn Gynecological Services in New York.

She told the doctor that she had been thrown off her jet ski in July 2018 and landed directly on her handlebars.

The accident left her a hematoma, a collection of solidified blood vessels, on her vulva that was about 12 centimeters long and she was in so much pain that she could not walk.

Her gynecologist told her that the hematoma should be emptied, but the woman was worried about scars, so the procedure was performed intravaginally instead of externally.

A 25-year-old woman from New York was left with a vulvar hematoma, a collection of solidified blood vessels in the vulva, after she landed on the wheel of her jet ski in an accident (file image)

A 25-year-old woman from New York was left with a vulvar hematoma, a collection of solidified blood vessels in the vulva, after she landed on the wheel of her jet ski in an accident (file image)

A vulvar hematoma is a collection of solidified blood vessels that merge into the vulva, which is the outer part of the vagina.

It occurs when blood vessels rupture, usually due to an injury, and blood collects in nearby tissues. Patients usually experience pain, swelling, discoloration of the skin and difficulty urinating.

Vulvar hematomas that are unrelated to childbirth are very rare. They have an incidence rate of about 3.7 percent and makeup less than one percent of all gynecological admissions in a hospital.

“Usually when someone has none expanding hematoma, if it is not actively bleeding, there is no need for immediately [surgical evacuation], “Dr. co-author Ghanshyam Yadav, an obstetrician / gynecologist at Baylor College of Medicine in Houston, Texas, told DailyMail.com.

“That can lead to more bleeding. You don’t want to cut into a part of the body that you don’t have to do, so you want to try conservative management first. “

This means that patients receive painkillers, anti-inflammatory drugs and ice bags in an attempt to reduce pain and swelling.

Dr. Yadav said the woman went to her local emergency room in New York immediately after the accident and was treated with these methods.

But by the time she arrived at Dr. Amir Marashi’s office in Brooklyn, New York, she was in so much pain that she could no longer walk.

Dr. Marashi – the so-called Vagina Whisper – examined the woman and found that her vitals were stable and that she had not broken her pelvis during the accident, which would require immediate surgery.

Because of how large the hematoma was – it covered her left labia or vaginal lip – it should be surgically emptied.

“It was almost like a grapefruit between her legs,” he told DailyMail.com. “It was a pretty big hematoma, very deep, and she couldn’t walk around.”

However, the patient was skeptical because she was worried about scars on her vulva.

‘Scar [on the genitalia] can be devastating for a patient, for their self-confidence, “said Dr. Yadav.

“Ultimately, the way male and female psychology works is that you have to be sexually comfortable with yourself.”

So Dr. decided Marashi to drain the hematoma intravaginally instead of externally, and made an incision in the left vaginal sidewall, which allowed minimal adhesion and scarring.

“They teach us [in residency] to make an external incision, “Dr. said. Marashi.

“I don’t know any schoolbook reports that show how to walk away from the inside and I said to her,” If it doesn’t work, we have to do this from the outside. “

“It’s more challenging and difficult because you don’t have direct access, but we’ve been able to empty the entire hematoma through this incision.”

According to the case report, the patient said after the procedure that her discomfort was resolved immediately.

“Once you have emptied the clot and evacuated the cavity, there is no more swelling so that the pressure is released again,” Dr. said. Yadav.

Because there is no consensus on practice guidelines, Dr. Marashi says surgeons should consider methods that can minimize scars.

“We must try more and more as doctors to do everything that is more cosmetic,” he said.

“Some people may think it’s vanity, but if you can eventually do it in a way that makes things look better, why wouldn’t you?”