The vulva (pudendum) is the collective term for the external female genitalia. It serves numerous important functions that are vital for good health, including acting as sensory tissue during sexual intercourse, assisting in micturition by directing the flow of urine, and protecting the internal female reproductive tract from infection.
Below, we shall explore the anatomy of the vulva in greater detail, including its structure, blood supply, and innervation.
The vulva is composed of several distinct anatomical structures, including:
The Bartholin’s glands (also known as the greater vestibular glands) can become infected and inflamed – known as bartholinitis. This is initially treated with antibiotics, but occasionally can be complicated by the formation of a cyst or abscess. In such cases, the only effective treatment is surgical drainage or excision of the lesion.
The arterial supply to the vulva is provided by the paired internal and external pudendal arteries, which are branches of the internal iliac artery and femoral artery, respectively. Venous drainage is achieved via the pudendal veins, with smaller labial veins contributing as tributaries. Lymph drains to the nearby superficial inguinal lymph nodes.
The vulva receives sensory and parasympathetic nervous supply. To describe the sensory distribution, the vulva can be divided into anterior and posterior sections: the anterior is innervated by the ilioinguinal nerve and the genital branch of the genitofemoral nerve, while the posterior is innervated by the pudendal nerve and the posterior cutaneous nerve of the thigh. The clitoris and the vestibule also receive parasympathetic innervation from the cavernous nerves – derived from the uterovaginal plexus.
Genital warts are benign growths of epithelium caused by certain HPV types, such as 6 and 11. They are highly infectious and are easily transmitted between sexual partners through sexual or even physical contact. However, they do not evolve into cancerous lesions. Other strains of HPV (most commonly high-risk types 16 and 18) may predispose affected individuals to dysplastic changes in the cervix, vagina, and/or anus, which can potentially lead to carcinoma.
Fortunately, recently developed HPV vaccines are safe and efficient in preventing high-risk HPV infections.
The Vulva is a complex anatomical structure consisting of various structures located around the vaginal orifice. These include the labia majora, labia minora, clitoris, Bartholin's glands, vulval vestibule, and hymen. To understand the clinical relevance of the Vulva, it is important to also understand the vascular supply, lymphatics, and innervation of the Vulva.
The arterial supply to the Vulva is provided by the paired internal and external pudendal arteries, which are branches of the internal iliac artery and femoral artery, respectively. Venous drainage is achieved via the pudendal veins, with smaller labial veins contributing as tributaries. The lymphatics of the Vulva drain to the inguinal lymph nodes, or the sacral lymph nodes.
The Vulva receives sensory and parasympathetic nervous supply. To describe the sensory distribution, the Vulva can be divided into anterior and posterior sections. The anterior section is innervated by the ilioinguinal nerve and the genital branch of the genitofemoral nerve, whereas the posterior section is innervated by the pudendal nerve and posterior cutaneous nerve of the thigh. The clitoris and the vestibule also receive parasympathetic innervation from the cavernous nerves, which are derived from the uterovaginal plexus.
The Bartholin’s glands, also known as the greater vestibular glands, can become infected and inflamed - known as bartholinitis. This is initially treated with antibiotics, but occasionally can be complicated by the formation of a cyst or abscess. In the case of an infected cyst or abscess, the only effective treatment is surgical drainage or excision of the lesion.
Genital warts are benign growths of epithelium caused by certain Human Papillomavirus (HPV) types, such as 6 & 11. These warts are highly infectious and are easily transmitted between sexual partners through sexual or even physical contact. However, they do not evolve into cancerous lesions. Other strains of HPV (most commonly high-risk types 16 & 18) may predispose affected individuals to dysplastic changes in the cervix, vagina and/or anus, which can potentially lead to carcinoma. Fortunately, recently developed HPV vaccines are safe and efficient in preventing high-risk HPV infections.
The Vulva is a complex anatomical structure with various structures located around the vaginal orifice. It is important to understand the clinical relevance of the Vulva, such as the infection of Bartholin's glands, which require treatment, and vulval warts, which can be prevented through HPV vaccines.
