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Chapter 65 - Algorithm for Managing Vulvovaginal Symptoms

from Section 12 - Miscellaneous

Published online by Cambridge University Press:  24 November 2021

By
Orna Reichman ,
Lynette J. Margesson ,
Cynthia A. Rasmussen ,
Ahinoam Lev-Sagie  and
Jack D. Sobel
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
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Summary

Bothersome genital symptoms (pruritus, irritation, dyspareunia, vaginal discharge, malodour, burning) are common problems. The main challenge for clinicians is to correctly diagnose the cause of the symptoms as they are non-specific and often have multiple overlapping aetiologies. The aim of this chapter, written by a multidisciplinary team of vulvovaginal experts (gynaecology, dermatology and infectious disease) is to present a clinical flow chart algorithm that can help the clinician reason through overlapping symptoms to obtain a more accurate diagnoses. Six principles were endorsed: (1) locating the discomfort (vulva, clitoris, vestibule, vagina, cervix, pelvis); (2) considering more than one entity; (3) evaluating each symptom separately (4) using pH and wet mount microscopy; (5) obtaining a follow-up visit after 2–4 weeks; (6) performing a biopsy for dermatological conditions that are resistant to treatment.

Keywords

vulvavaginaalgorithmgenital symptomsdermatology
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 544 - 551
Publisher: Cambridge University Press
Print publication year: 2021

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References

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