The vulva refers to the external female genitalia, encompassing all the visible parts located around the vaginal opening. It’s crucial to understand that the vulva is not the same as the vagina; the vagina is the internal canal leading from the vulva to the cervix. The vulva plays a vital role in sexual function, urination, and protection against infection. Understanding its anatomy is key to overall women’s health.
The vulva is composed of several distinct parts, each with a specific function:
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Labia Majora: These are the outer, larger folds of skin that are often covered in pubic hair after puberty. They are analogous to the scrotum in males and serve to protect the more delicate inner structures of the vulva.
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Labia Minora: Situated inside the labia majora, these are two smaller, more delicate folds of skin. The labia minora are hairless and rich in nerve endings and blood vessels, making them highly sensitive. They surround the vaginal opening and the urethra.
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Clitoris and Prepuce: At the front of the vulva, where the labia minora meet, they form a hood-like covering called the prepuce or clitoral hood. Beneath this prepuce lies the clitoris, a small but highly sensitive organ, primarily responsible for sexual pleasure. It is composed of erectile tissue that becomes engorged with blood during sexual stimulation. The clitoris is analogous to the penis in males, sharing similar embryological origins and nerve endings.
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Vestibule: This is the area enclosed by the labia minora. Within the vestibule, you’ll find the openings to the urethra (the tube through which urine passes from the bladder) and the vagina.
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Bartholin’s Glands: Located on each side of the vaginal opening, just inside the labia minora, are the Bartholin’s glands. These glands secrete a mucus-like fluid that acts as a lubricant, particularly during sexual activity.
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Fourchette and Perineum: The labia minora also meet at the back of the vaginal opening, forming the fourchette. The area between the fourchette and the anus (the opening for bowel movements) is called the perineum.
It’s important to be aware of vulvar cancer, although it is relatively rare. Vulvar cancer occurs when cells in the vulva grow uncontrollably. It most commonly affects the labia majora or labia minora but can also occur in the clitoris or Bartholin’s glands.
Types of Vulvar Cancer
Vulvar cancers are categorized based on the type of cells where the cancer originates.
Squamous Cell Carcinoma
The most prevalent type of vulvar cancer is squamous cell carcinoma. This cancer develops in the squamous cells, which are the primary cells on the skin’s surface. There are several subtypes:
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Keratinizing Squamous Cell Carcinoma: The most common subtype, typically seen in older women and often not linked to Human Papillomavirus (HPV).
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Basaloid and Warty Squamous Cell Carcinoma: Less common and more frequently associated with HPV infections, often found in younger women.
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Verrucous Carcinoma: A rare, slow-growing subtype that resembles a large wart. It has a generally favorable prognosis if identified and treated properly.
Adenocarcinoma
Adenocarcinoma originates in gland cells. In the vulva, these often arise in the Bartholin’s glands. Bartholin gland cancers are frequently adenocarcinomas and can be mistaken for benign cysts, potentially delaying diagnosis. Adenocarcinomas can also develop in sweat glands within the vulvar skin.
Paget Disease of the Vulva is a condition where adenocarcinoma cells are present in the outer layer of vulvar skin. It can be associated with an underlying invasive adenocarcinoma.
Melanoma
Melanoma is a cancer arising from melanocytes, the pigment-producing cells in the skin. While more common on sun-exposed skin, melanoma can occur on the vulva. Vulvar melanomas are rare, representing a small percentage of vulvar cancers.
Sarcoma
Sarcomas are cancers of the connective tissues, such as muscles or bones. Vulvar sarcomas are very rare and can occur in females of any age, including children.
Basal Cell Carcinoma
Basal cell carcinoma, the most common type of skin cancer overall, is extremely rare on the vulva and typically found in sun-exposed areas.
Understanding the anatomy of the vulva and the types of cancers that can affect it is crucial for women’s health awareness. Any changes or concerns in the vulvar area should be discussed with a healthcare provider for proper evaluation and care.
