Vulval disorders

​​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Acute painful enlargement of a Bartholin's gland, cyst or abscess
  • Acute painful presentation with a vulval cyst or abscess
  • Acute trauma, including any of the following features:
    • Haematoma
    • Penetrating injuries
    • Vulval or vaginal lacerations

When public outpatient services are not routinely provided

  • Any skin abnormality that is part of a widespread skin disorder
    Note: referral to dermatologist is indicated
  • Cosmetic vulval procedures and any associated complications (e.g. labioplasty)
  • Histopathologically confirmed vulval malignancy
    Note: referral to gynaecological oncology is indicated, where 

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Immunosuppressed patient with a vulval lesion
  • Suspected malignancy on appearance
  • Unexplained vulval lesion, ulceration or bleeding​
​Category 2
Recommended to be seen within 90 calendar days.
​
  • Post-menopausal patient with persistent vaginal discharge
  • Suspicion of vaginal agglutination due to erosive lichen planus
  • Vulval dermatoses, including lichen sclerosus requiring diagnosis or not responding to treatment
  • Vulval warts with any of the following features:
    • Atypical presentation (including pigmented lesions)
    • Diagnosis is unclear​

Category 3
Recommended to be seen within 365 calendar days.

  • Chronic candidiasis not responding to treatment
  • Chronic, unexplained vulval pruritus
  • Hidradenitis or chronic sinus tract with recurrent vulval abscesses
  • Pre-menopausal patient with abnormal, persistent vaginal discharge
  • Recurrent and symptomatic Bartholin's or vulval cysts < 3 cm
  • Uncomplicated vulval warts not responding to treatment
  • Vulvodynia
    Note: consider concurrent referral to pelvic floor physiotherapy for vestibulodynia management
  • Well-controlled lichen sclerosis with a concern needing review ​

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Hormonal contraception use
    • History of presenting symptoms
    • Vulval examination findings
    • Relevant histopathology, swabs or imaging reports
    • Cervical screening test within the last 5 years
    • Sexually transmitted infection (STI) screen (if sexually active)
    • Herpes simplex virus and varicella-zoster virus polymerase chain reaction (PCR) screen (if ulcerated lesion)​​

If available

  • ​​Body mass index

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing