Vulvar cramping is a symptom of a heavy sensation in the vulva due to vulvar smooth muscle tumors or vaginal inflammation. The principle of treatment for vulvar smooth muscle tumor is local excision of tipped fibroids or removal of deep fibroids. The prevention of vaginal inflammation is to abandon antibiotic abuse, wash underwear separately, avoid over-cleaning, pay attention to care during pregnancy, be wary of washing machines, and pay attention to hygiene in public places. Diagnosis and examination of vulvovaginal hypospadias: the diagnosis is made by the patient’s self-perceived symptoms. Differential diagnosis of vulvovaginal cramps: 1. Non-specific vaginitis: smear of secretion and microscopic examination with Gram stain can find common pathogens without the presence of mycobacteria or trichomonas. 2, mycosis fungoides: take a smear of the secretion and stain it with Gram stain. Microscopically, groups of Gram-positive intensely stained ovoid spores can be found, or pseudomycorrhizal filaments can be seen connected with outgrowth cells in a chain or branched form. The most reliable method is to perform a mycological culture test. 3. Trichomonas vaginalis: Take the discharge and mix it with a small amount of warm saline that has been dripped on a glass slide and examine it microscopically. Active Trichomonas vaginalis can be seen. If trichomonas cannot be detected in special cases, culture test can be used instead and the results are highly accurate. 4. senile vaginitis: taking secretions for examination should be distinguished from trichomoniasis and mycosis. Pay attention to the cervix, uterine body size and its morphology, source of bleeding and vaginal cytology results, and make cervical or endometrial biopsy if necessary to exclude the possibility of uterine cancer. 5.Vulvar smooth muscle tumor: vulvar smooth muscle tumor is usually found in the clitoris, labia majora and labia minora, usually single, round or oval in shape, with smooth surface, hard texture, envelope and good activity. Vulvar smooth muscle tumors mostly originate from the smooth muscle of the vulva, hair follicles or smooth muscle of blood vessels. On pathological examination, smooth muscle cells can be seen microscopically in longitudinal, parallel or swirling arrangement, with eosinophilic cytoplasm, long rod-shaped nucleus, bluntly rounded ends, halo-like spaces around the nucleus, and fibrous interstitium between muscle bundles. It is easy to be misdiagnosed because it is rare in clinical practice. Its mass is hard and can be differentiated from vulvar lipoma; its solid mass with good activity, no surface rupture and no history of pus flow can be differentiated from Bartholin’s gland abscess and Bartholin’s gland cyst. The differential diagnosis with other diseases also includes: vulvar sebaceous cysts are generally small and soft, and the cysts contain foul-smelling yellow sebum-like material; vulvar papillomas are mostly seen in elderly women, with papillary or warty protrusions; vulvar fibromas are hard, smooth and lobulated, and can be cystic when degeneration occurs, with a dense pale surface and woven structures; vulvar carcinomas are mostly scratchy, ruptured, with more exudate Vulvar carcinoma has itching, rupture, more exudate and purulent discharge, irregular mass shape, unclear basal boundary, and metastasis symptoms; vulvar sebaceous adenoma mostly occurs in labia minora, smaller and harder. The final diagnosis can only be confirmed by pathological examination. The treatment of this disease is mainly surgical excision, and no malignant transformation has been reported.