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In the emergency care setting, traumatic injuries to the vulva may be seen. Accidental injuries may occur in the setting of athletic activities such as bicycling or from a fall, and may cause lacerations or hematomas. Sexual assault and accidental injuries associated with sexual activity are the most common cause of vulvar trauma (7).

Obstetrical lacerations and episiotomies may be associated with chronic peri-neal pain as well as the formation of neuromas or scar tissue. Genital piercing is becoming increasingly common and generally involves the labia minora or clitoris. It may be associated with cellulitis or trauma during sexual activity.

Female genital cutting or circumcision is practiced in many countries in Africa and some in Asia. While this custom exists within the complex, religious, cultural, and familial structure of these societies, it is important for physicians to be familiar with the potential health consequences of this practice. There are three types of female circumcision:

• Type I: Excision of the prepuce with or without part or the entire clitoris

• Type II: Excision of the prepuce and clitoris along with part or all of the labia minora

• Type III: Excision of all or most of the external genitalia with closure of the vaginal opening (infibulation)

Chronic pain, recurrent vaginal infections, sebaceous and inclusion cysts, urinary incontinence, difficulty with sexual activity, and obstetrical complications are all potential sequelae (10).

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