Orna Reichman1,2, Lynette J Margesson3, Cynthia A Rasmussen4, Ahinoam Lev-Sagie5, Jack D Sobel6. 1. Division of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel. orna.reich@gmail.com. 2. Division - OBGYN, Shaare Ze[dek Medical Center, Hebrew University Medical School, Jerusalem, Israel. orna.reich@gmail.com. 3. Department of Obstetrics & Gynecology and Surgery (Dermatology), Geisel School of Medicine at Dartmouth, Hanover, NH, USA. 4. Obstetrics Gynecology & Repro. Biology, Beth Israel Deaconess Medical Center, Harvard Vanguard Medical Associates, Burlington, MA, USA. 5. Vulvovaginal Disorders Clinic, Clalit Health Organization, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. 6. Wayne State University, Detroit, MI, USA.
Abstract
PURPOSE OF REVIEW: To present a comprehensive systematic approach for diagnosing correctly the cause(s) of bothersome genital symptoms. RECENT FINDINGS: We searched the PUBMED for practical clinical guidelines, written by a multidisciplinary team of healthcare providers directed for diagnosing bothersome genital symptoms. This search was performed by a professional information specialist using the keywords "vulvovaginal," "vulvar," "multidisciplinary diagnosis," "interdisciplinary consultation," and "vulvology." We found numerous publications defining the criteria for diagnosing specific disorders, but only a few publications presented a multidisciplinary clinical algorithm for diagnosing bothersome vulvovaginal symptoms. The authors, from three different specialities, gathered together (online), in aim to present a comprehensive systematic approach for accurate diagnosing of bothersome vulvovaginal symptoms. Six principles for accurately diagnosing a woman with bothersome genital symptoms were endorsed: (1) locate the discomfort (vulva, clitoris, vestibule, vagina, cervix, pelvis); (2) consider more than one entity; (3) evaluate each symptom separately (it is common to have more than one entity necessitating treatment for each); (4) use pH and wet mount microscopy; (5) obtain a follow-up visit in 2-4 weeks; (6) perform a biopsy for dermatological conditions that are resistant to treatment.
PURPOSE OF REVIEW: To present a comprehensive systematic approach for diagnosing correctly the cause(s) of bothersome genital symptoms. RECENT FINDINGS: We searched the PUBMED for practical clinical guidelines, written by a multidisciplinary team of healthcare providers directed for diagnosing bothersome genital symptoms. This search was performed by a professional information specialist using the keywords "vulvovaginal," "vulvar," "multidisciplinary diagnosis," "interdisciplinary consultation," and "vulvology." We found numerous publications defining the criteria for diagnosing specific disorders, but only a few publications presented a multidisciplinary clinical algorithm for diagnosing bothersome vulvovaginal symptoms. The authors, from three different specialities, gathered together (online), in aim to present a comprehensive systematic approach for accurate diagnosing of bothersome vulvovaginal symptoms. Six principles for accurately diagnosing a woman with bothersome genital symptoms were endorsed: (1) locate the discomfort (vulva, clitoris, vestibule, vagina, cervix, pelvis); (2) consider more than one entity; (3) evaluate each symptom separately (it is common to have more than one entity necessitating treatment for each); (4) use pH and wet mount microscopy; (5) obtain a follow-up visit in 2-4 weeks; (6) perform a biopsy for dermatological conditions that are resistant to treatment.