Paediatric vulvar disease

Simpson, Rosalind; Murphy, Ruth

doi:10.1016/j.bpobgyn.2014.07.004

Cited by 11 publications

(13 citation statements)

References 41 publications

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“…Education on vulvar hygiene is essential for both children and parents, making them aware of possible allergens and irritants, and hence the recommendation for the use of natural emollients (such as coconut oil) is useful [4,5,11]. Vulvar pressure by some inappropriate cloths should be avoided, according to children's preferences.…”

Section: Discussionmentioning

confidence: 99%

“…Vulvar and anal examination: specific focus on vulvar and perianal skin, mucosa and discharge (if present) for diagnosis other than vulvodynia. Parents were assured that in prepubertal girls, normal vestibular mucosa is more often red rather than pink, due to lack of estrogens [5]. Vaginal discharge was always noted in the presence of any foreign bodies (toilet paper or toy), these exams were possible when the child was asked to take deep breaths in and out, thus dilating the vaginal opening.…”

Section: Methodsmentioning

confidence: 99%

“…Looking for causes of skin irritation, redness, small fissures, blisters like herpes simplex lesions, varicella and other ulcers (aphthous, Behcet or Crohn disease related), where present, these were identified. Signs of genital trauma, abuse [5] or any other injuries were noted. In any chronic vulvar pain cases the anus was also visually examined so as not to overlook possible anal fissure (which commonly appears at the 12 or 6 o'clock position -visualize a pelvic clock as reference).…”

Section: Methodsmentioning

confidence: 99%

“…Lab tests: a diagnostic swab was taken from the vestibulum when discharge or skin erythema was noted, or reported by the mother, to exclude the presence of specific bacteria. Vulvovaginal yeast infections are rare in prepubertal girls [5]. Pinworms should also be excluded by a tap test.…”

Section: Methodsmentioning

confidence: 99%

“…Any vaginal discharge must be noted. Labial adhesions, when seen in prepubertal girls, are common and asymptomatic [5]. Foreign bodies in the vagina are not felt by the patient, unless they protrude to the vestibule, and these are rarely the cause of vulvar pain, vaginal discharge is present in such cases.…”

Section: Introductionmentioning

confidence: 99%

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Vulvodynia in prepubertal girls: diagnosis

Paszkowski

Baszak-Radomańska²

2021

Ginekol Pol

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Objectives: To identify specific features of vulvodynia in prepubertal girls, highlight potential triggers and concomitant diseases, outline diagnostic criteria is neglected problem in adolescent gynecology. Material and methods:A retrospective study, based on medical records of an outpatient clinic, a cohort of 54 vulvodynia cases was evaluated, aged 3-10 years, seen between January 2016 and July 2018. Results:The study cohort presented with pain (61%), sometimes aggravated at night, pruritus (44%) and a range of other varied and unusual vulvar complaints (26%). Concomitant diseases and/or psychological problems were present in 61% of cases. Overactive pelvic muscles accompanying symptoms like urological or gastrological problems were noted in half of children. Several potential triggers were identified in a third of the cases that were emotionally stressful to the children. From the commencement of symptoms, 93% of the girls have consulted more than one doctor with 43% seeing more than three doctors, without receiving a diagnosis of vulvodynia. Conclusions:A diagnosis of vulvodynia needs to be considered in the absence of vulva pathology with wide range of vulvar pain, pruritus and discomfort. All persistent or recurrent vulvar discomfort must be taken into consideration as a vulvodynia symptom, also various non-specific, worrisome complaints. Comorbid urological and gastrological symptoms associated with overactive pelvic muscles should not be overlooked. Chronic pain can be triggered by the psychological distress in some prepubertal girls. Proper diagnosis may prevent long-term negative sequelae, what emphasizes the need for professional education of healthcare providers in adolescent vulvar pain and discomfort.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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