Amy Hansen1, Kirsten Carr, Jeffrey T Jensen. 1. School of Medicine, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, USA.
Abstract
OBJECTIVE: To describe the demographics, presenting symptoms, physical examination and laboratory findings, and initial diagnoses in a cohort of women referred for evaluation of vulvovaginal problems. STUDY DESIGN: Descriptive review of medical records of new patients referred for evaluation of vulvar problems between January 1, 1996, and December 31, 1999. Electronic medical records and other documents were manually abstracted. RESULTS: Three hundred twenty-two women met the study criteria. The majority were Caucasian (93.8%) and married (63.9%). The mean age was 41 years, with a range of 13-88. The majority reported at least one vaginal delivery (72.9%) or cesarean section (10.6%). The most common symptoms were vulvar pain (86.3%), dyspareunia (70.8%), itching (36.0%) and skin changes (18.0%). Most patients received a diagnosis in more than one evaluation category. Prevalent diagnoses included Bartholin fossa pain (12.1%), vulvar vestibulitis (19.9%), restriction and fissuring of the posterior labial commissure (20.1%), dysesthetic vulvodynia (32.3%), pelvic floor dysfunction (39.8%) and dermatologic conditions (47.5%). CONCLUSION: Women presenting for evaluation of vulvar disorders represent a heterogeneous population. Among women with vulvar pain, abnormalities of the skin and pelvic floor are common and should be ruled out prior to making a diagnosis of vulvar vestibulitis or dysesthetic vulvodynia.
OBJECTIVE: To describe the demographics, presenting symptoms, physical examination and laboratory findings, and initial diagnoses in a cohort of women referred for evaluation of vulvovaginal problems. STUDY DESIGN: Descriptive review of medical records of new patients referred for evaluation of vulvar problems between January 1, 1996, and December 31, 1999. Electronic medical records and other documents were manually abstracted. RESULTS: Three hundred twenty-two women met the study criteria. The majority were Caucasian (93.8%) and married (63.9%). The mean age was 41 years, with a range of 13-88. The majority reported at least one vaginal delivery (72.9%) or cesarean section (10.6%). The most common symptoms were vulvar pain (86.3%), dyspareunia (70.8%), itching (36.0%) and skin changes (18.0%). Most patients received a diagnosis in more than one evaluation category. Prevalent diagnoses included Bartholin fossa pain (12.1%), vulvar vestibulitis (19.9%), restriction and fissuring of the posterior labial commissure (20.1%), dysesthetic vulvodynia (32.3%), pelvic floor dysfunction (39.8%) and dermatologic conditions (47.5%). CONCLUSION:Women presenting for evaluation of vulvar disorders represent a heterogeneous population. Among women with vulvar pain, abnormalities of the skin and pelvic floor are common and should be ruled out prior to making a diagnosis of vulvar vestibulitis or dysesthetic vulvodynia.