Vulvar Hematoma
Hematomas occurring in the vulva may result from a variety of causes: episiotomy, traumatic forceps delivery, therapeutic vulvar or lower vaginal injection, vulvar surgery, and vulvar trauma, to mention a few.
Regardless of the cause(s), the end result may be the deposit of a massive amount of blood subcutaneously, typically along the plane of Colles’ fascia or below it (Fig. 73–1). Coupled with the factors previously noted may be disruption of one of the structures forming the “blood lake” situated between Colles’ fascia and the fascia encompassing the levator ani muscles. These cavernous structures (clitoris, bulb and vestibule, and corpora cavernosa) can and will bleed without remission for long periods, as manifested by a constant slow ooze.
