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Section 6 - Vulva and Vagina

Published online by Cambridge University Press:  24 November 2021

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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The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 237 - 274
Publisher: Cambridge University Press
Print publication year: 2021

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References

References

Bornstein, J, Goldstein, AT, Stockdale, CK, et al. 2015 ISSVD, ISSWSH, and IPPS consensus terminology and classification of persistent vulval pain and vulvodynia. J Low Genit Tract Dis 2016;20:126–130.Google Scholar
Bornstein, J, Preti, M, Simon, JA, et al. Descriptors of vulvodynia: a multisocietal definition consensus (International Society for the Study of Vulvovaginal Disease, the International Society for the Study of Women Sexual Health, and the International Pelvic Pain Society). J Low Genit Tract Dis 2019;23:161–163.Google Scholar
De Andres, J, Sanchis-Lopez, N, Asensio-Samper, JM, et al. Vulvodynia: an evidence-based literature review and proposed treatment algorithm. Pain Pract 2016;16:204–236.CrossRefGoogle ScholarPubMed
Woolf, CJ. What is this thing called pain? J Clin Invest 2010;120:3742–3744.CrossRefGoogle ScholarPubMed
Woolf, CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain 2011;152(3 Suppl.):S2–S15.CrossRefGoogle ScholarPubMed
Von Hehn, CA, Baron, R, Woolf, CJ. Deconstructing the neuropathic pain phenotype to reveal neural mechanisms. Neuron 2012;73:638–652.Google Scholar
Micheletti, L, Radici, G, Lynch, PJ. Provoked vestibulodynia: inflammatory, neuropathic or dysfunctional pain? A neurobiological perspective. J Obstet Gynaecol 2014;34:285–288.CrossRefGoogle ScholarPubMed
Micheletti, L, Radici, G, Lynch, PJ. Is the 2003 ISSVD terminology and classification of vulvodynia up-to-date? A neurobiological perspective. J Obstet Gynaecol 2015;35:788–792.CrossRefGoogle ScholarPubMed
Haanpää, M, Attal, N, Backonja, M, et al. NeuPSIG guidelines on neuropathic pain assessment. Pain 2011;152:14–27.CrossRefGoogle ScholarPubMed
Stockdale, CK, Lawson, HW. 2013 vulvodynia guideline update. J Low Genit Tract Dis 2014;18:93–100.CrossRefGoogle ScholarPubMed

References

Cooper, SM, Arnold, S. Vulvar lichen sclerosus. UpToDate. 2018.Google Scholar
Akel, R, Fuller, C. Updates in lichen sclerosis: British Association of Dermatologists guidelines for the management of lichen sclerosus 2018. Br J Dermatol 2018;178: 823–824.CrossRefGoogle ScholarPubMed
Renaud-Vilmer, C, Cavelier-Balloy, B, Porcher, R, Dubertret, L. Vulvar lichen sclerosus: effect of long-term topical application of a potent steroid on the course of the disease. Arch Dermatol 2004;140:709–712.CrossRefGoogle ScholarPubMed
Cooper, SM, Gao, XH, Powell, JJ, Wojnarowska, F. Does treatment of vulvar lichen sclerosus influence its prognosis? Arch Dermatol 2004;140:702–706.CrossRefGoogle ScholarPubMed
Boyd, AS, Neldner, KH. Lichen planus. J Am Acad Dermatol 1991;25:593–619.Google Scholar
Carrozzo, M. How common is oral lichen planus? Evid Based Dent 2008;9:112–113.Google Scholar
Cooper, S. Vulvar lichen planus. UpToDate. 2017.Google Scholar
Helgesen, AL, Gjersvik, P, Jebsen, P, Kirschner, R, Tanbo, T. Vaginal involvement in genital erosive lichen planus. Acta Obstet Gynecol Scand 2010;89:966–970.CrossRefGoogle ScholarPubMed
Helgesen, AL, Warloe, T, Pripp, AH, et al. Vulvovaginal photodynamic therapy vs. topical corticosteroids in genital erosive lichen planus: a randomized controlled trial. Br J Dermatol 2015;173:1156–1162.Google Scholar
Cooper, SM, Wojnarowska, F. Influence of treatment of erosive lichen planus of the vulva on its prognosis. Arch Dermatol 2006;142:289–294.CrossRefGoogle ScholarPubMed
Anderson, M, Kutzner, S, Kaufman, RH. Treatment of vulvovaginal lichen planus with vaginal hydrocortisone suppositories. Obstet Gynecol 2002;100:359–362.Google ScholarPubMed
Lotti, T, Buggiani, G, Prignano, F. Prurigo nodularis and lichen simplex chronicus. Dermatol Ther 2008;21:42–46.Google Scholar
Lynch, PJ. Lichen simplex chronicus (atopic/neurodermatitis) of the anogenital region. Dermatol Ther 2004;17:8–19.CrossRefGoogle ScholarPubMed
Konuk, N, Koca, R, Atik, L, et al. Psychopathology, depression and dissociative experiences in patients with lichen simplex chronicus. Gen Hosp Psychiatry 2007;29:232–235.Google Scholar
Yesudian, PD, Wilson, NJ. Efficacy of gabapentin in the management of pruritus of unknown origin. Arch Dermatol 2005;141:1507–1509.CrossRefGoogle ScholarPubMed
Kouwenhoven, TA, vandeKerkhof, PCM, Kamsteeg, M. Use of oral antidepressants in patients with chronic pruritus: a systematic review. J Am Acad Dermatol 2017;77:1068–1073.e7.CrossRefGoogle ScholarPubMed
Elsner, P, Wilhelm, D, Maibach, HI. Multiple parameter assessment of vulvar irritant contact dermatitis. Contact Dermatitis 1990;23:20–26.CrossRefGoogle ScholarPubMed
Margesson, LJ. Contact dermatitis of the vulva. Dermatol Ther 2004;17:20–27.Google Scholar
Johnson, N, Sheinman, P, Watson, A. Vulvar dermatitis. UpToDate. 2018.Google Scholar
Cohen, DE, Heidary, N. Treatment of irritant and allergic contact dermatitis. Dermatol Ther 2004;17:334–340.CrossRefGoogle ScholarPubMed
Johnston, GA, Exton, LS, Mohd Mustapa, MF, et al. British Association of Dermatologists’ guidelines for the management of contact dermatitis 2017. Br J Dermatol 2017;176:317–329.Google Scholar
Bharatia, PR, Pradhan, AM, Zawar, VP. Plasma cell vulvitis. Indian J Sex Transm Dis AIDS 2015;36:185–187.Google Scholar
Page, S, Tait, C, Dykstra, C, et al. Plasma cell vulvitis: a case series. J Am Acad Dermatol 2015;72:AB58.Google Scholar
Damiani, L, Quadros, M, Posser, V, Minotto, R, Boff, AL. Zoon vulvitis. An Bras Dermatol 2017;92(5;Suppl. 1):166–168.Google Scholar
Virgili, A, Borghi, A, Minghetti, S, Corazza, M. Comparative study on topical immunomodulatory and anti-inflammatory treatments for plasma cell vulvitis: long-term efficacy and safety. J Eur Acad Dermatol Venereol 2015;29:507–514.CrossRefGoogle ScholarPubMed
Feldman, SR. Epidemiology, clinical manifestations, and diagnosis of psoriasis. UpToDate. 2018.Google Scholar
Beck, KM, Jang, EJ, Sanchez, IM, Liao, W. Treatment of genital psoriasis: a systematic review. Dermatol Ther (Heidelb) 2018;8:509–525.Google Scholar
Yang, EJ, Beck, KM, Sanchez, IM, Koo, J, Liao, W. The impact of genital psoriasis on quality of life: a systematic review. Psoriasis (Auckl) 2018;8:41–47.Google ScholarPubMed
Meeuwis, KA, de Hullu, JA, Massuger, LF, van de Kerkhof, PC, van Rossum, MM. Genital psoriasis: a systematic literature review on this hidden skin disease. Acta Derm Venereol 2011;91:5–11.Google Scholar
Zouboulis, CC, Desai, N, Emtestam, L, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol 2015;29:619–644.CrossRefGoogle ScholarPubMed
Vekic, DA, Frew, J, Cains, GD. Hidradenitis suppurativa, a review of pathogenesis, associations and management. Part 1. Australas J Dermatol 2018;59:267–277.Google Scholar
Gulliver, W, Zouboulis, CC, Prens, E, et al. Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa. Rev Endocr Metab Disord 2016;17:343–351.CrossRefGoogle Scholar
Ingram, JR. Hidradenitis suppurativa: pathogenesis, clinical features, and diagnosis. UpToDate. 2018.Google Scholar
Tolaas, E, Knudsen, CW, Sviland, L, Tonseth, KA. [Hidradenitis suppurativa]. Tidsskr Nor Laegeforen 2009;129:992–996.Google Scholar
Lacey, CJ, Woodhall, SC, Wikstrom, A, Ross, J. 2012 European guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol 2013;27: e263–e270.CrossRefGoogle ScholarPubMed
Scheinfeld, N. Condylomata acuminata (anogenital warts) in adults: epidemiology, pathogenesis, clinical features, and diagnosis. UpToDate. 2017.Google Scholar
Mendoza, N, Tyring, SK. Genital warts. BMJ Best Practice Guidelines. 2018.Google Scholar

References

Drake, R, Vogl, AW, Mitchell, A. Grays Basic Anatomy, 2nd edition. Amsterdam: Elsevier; 2018.Google Scholar
Yavagal, S, de Farias, TF, Medina, CA, Takacs, P. Normal vulvovaginal, perineal, and pelvic anatomy with reconstructive considerations. Semin Plast Surg 2011;25:121–129.Google Scholar
The North American Menopause Society. Management of symptomatic vulvovaginal atrophy: 2013 position statement of the North American Menopause Society. Menopause 2013;20:888–902;CrossRefGoogle Scholar
Buchanan, DL, Kurita, T, Taylor, JA, et al. Role of stromal and epithelial estrogen receptors in vaginal epithelial proliferation, stratification and cornification. Endocrinology 1998;139:4345–4352.CrossRefGoogle ScholarPubMed
Anderson, MR, Klink, K, Cohrssen, A. Evaluation of vaginal complaints. JAMA 2004;291:1368–1379.CrossRefGoogle ScholarPubMed
Portman, DJ, Gass, MLS. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Menopause 2014;21:1063–1068.Google Scholar
Mitchell, CM, Waetjen, LE. Genitourinary changes with aging. Obstet Gynecol Clin North Am 2018;45:737–750.Google Scholar
Santoro, N, Komi, J. Prevalence and impact of vaginal symptoms among postmenopausal women. J Sex Med 2009;6:2133–2142.Google Scholar
Palma, F, Volpe, A, Villa, P, Gagnacci, A. Vaginal atrophy of women in postmenopause: results from a multicentric observational study – the AGATA study. Maturitas 2016;83:40–44.Google Scholar
Cagnacci, A, Xholli, A, Sclauzero, M, et al. Vaginal atrophy across the menopausal age: results from the ANGEL study. Climacteric 2019;22:85–89.CrossRefGoogle ScholarPubMed
Palacios, S, Nappi, RE, Bruyniks, N, et al. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric 2018;21:286–291.Google Scholar
Kingsberg, SA, Krychman, M, Graham, S, Bernick, B, Mirkin, S. The Women’s EMPOWER Survey: identifying women’s perceptions on vulvar and vaginal atrophy and its treatment. J Sex Med 2017;14:413–424.Google Scholar
Huang, AJ, Gregorich, SE, Kuppermann, M, et al. Day-to-Day Impact of Vaginal Aging questionnaire: a multidimensional measure of the impact of vaginal symptoms on functioning and well-being in postmenopausal women. Menopause 2015;22:144–154.Google Scholar
Meisels, A. The maturation value. Acta Cytol 1967;11:249.Google Scholar
Bachmann, G, Santen, RJ. Treatment of vaginal atrophy. UpToDate. 2014. Available at: www.uptodate.com/treatment-of-vaginalatrophy.Google Scholar
The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause 2017;24:728–753.CrossRefGoogle Scholar
Shifren, JL. Genitourinary syndrome of menopause. Clin Obstet Gynecol 2018;61:508–516.Google Scholar
Lev-Sagie, A. Vulvar and vaginal atrophy: physiology, clinical presentation, and treatment considerations. Clin Obstet Gynecol 2015;58:476–491.Google Scholar
Lethaby, A, Ayeleke, RO, Roberts, H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2016;31:CD001500.Google Scholar
Mitchell, CM, Reed, SD, Diem, S, et al. Efficacy of vaginal estradiol or vaginal moisturizer vs placebo for treating postmenopausal vulvovaginal symptoms: a randomized clinical trial. JAMA Intern Med 2018;178:681–690.CrossRefGoogle ScholarPubMed
Labrie, F, Archer, DF, Koltun, W, et al. Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause. Menopause 2018;25:1339–1353.Google Scholar
Elkinson, S, Yang, LP. Ospemifene: first global approval. Drugs 2013;73:605–612.Google Scholar
Donato, V, Schiavi, MC, Iacobelli, V, et al. Ospemifene for the treatment of vulvar and vaginal atrophy: a meta-analysis of randomized trials. Part I: evaluation of efficacy. Maturitas 2019;121:86–92.Google Scholar
Reichman, O, Sobel, J. Desquamative inflammatory vaginitis. Best Pract Res Clin Obstet Gynaecol 2014;28: 1042–1050.Google Scholar
Sobel, JD, Reichman, O, Misra, D, Yoo, W. Prognosis and treatment of desquamative inflammatory vaginitis. Obstet Gynecol 2011;117:850–855.Google Scholar
Sobel, JD. Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Am J Obstet Gynecol 1994;171:1215–1220.Google Scholar
Donders, GG, Vereecken, A, Bosmans, E, et al. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG 2002;109:34–43.Google Scholar
Peacocke, M, Djurkinak, E, Thys-Jacobs, S. Treatment of desquamative inflammatory vaginitis with vitamin D: a case report. Cutis 2008;81: 75–78.Google ScholarPubMed
Shaw, JL, Diamandis, EP. A potential role for tissue kallikrein-related peptidases in human cervico-vaginal physiology. Biol Chem 2008;389: 681–688.Google Scholar

References

Gatta, G, Capocaccia, R, Botta, L, et al. Burden and centralised treatment in Europe of rare tumours: results of RARECAREnet – a population-based study. Lancet Oncol 2017;18:1022–1039.Google Scholar
Noone, AM, Howlader, N, Krapcho, M, et al. SEER Cancer Statistics Review, 1975–2015. Bethesda, MD: National Cancer Institute.Google Scholar
Hampel, M, Deckers-Figiel, S, Hapl, JA, Rein, D, Bender, HG. New aspects of vulvar cancer: changes in localization and age of onset. Gynecol Oncol 2008;109:340–345.Google Scholar
Al-Ghamdi, A, Freedman, D, Miller, D, et al. Vulvar squamous cell carcinoma in young women: a clinicopathologic study of 21 cases. Gynecol Oncol 2002;84:94–101.Google Scholar
Jones, RW, Baranyai, J, Stables, S. Trends in squamous cell carcinoma of the vulva: the influence of vulva intraepithelial neoplasia. Obstet Gynecol 1997;90:448–452.Google Scholar
Skapa, P, Zamecnik, J, Hamsikova, E, et al. Human papillomavirus (HPV) profiles of vulvar lesions: possible implications for the classification of vulvar squamous cell carcinoma precursors and for the efficacy of prophylactic HPV vaccination. Am J Surg Pathol 2007;31:1834–1843.Google Scholar
Hoevenaars, BM, van der Avoort, IA, de Wilde, PC, et al. A panel of p16(INK4A), MIB1 and p53 proteins can distinguish between the 2 pathways leading to vulvar squamous cell carcinoma. Int J Cancer 2008;123:2767–2773.Google Scholar
Del Pino, M, Rodriguez-Carunchio, L, Ordi, J. Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma. Histopathology 2013;62:161–175.Google Scholar
Wilkinson, EJ. Premalignant and malignant tumors of the vulva. In: Blaustein’s Pathology of the Female Genital Tract. New York: Springer; 2011, pp. 106–154.Google Scholar
Ansink, A, van der Velden, J. Surgical interventions for early squamous cell carcinoma of the vulva. Cochrane Database Syst Rev 2000;2:CD002036.Google Scholar
Micheletti, L, Preti, M, Zola, P, et al. A proposed glossary of terminology related to the surgical treatment of vulvar carcinoma. Cancer 1998;83:1369–1375.3.0.CO;2-2>CrossRefGoogle Scholar
Heaps, JM, Fu, YS, Montz, FJ, Hacker, NF, Berek, JS. Surgical-pathologic variables predictive of local recurrence in squamous cell carcinoma of the vulva. Gynecol Oncol 1990;38:309–314.Google Scholar
Burke, TW, Levenback, C, Coleman, RL, et al. Surgical therapy of T1 and T2 vulvar carcinoma: further experience with radical wide excision and selective inguinal lymphadenectomy. Gynecol Oncol 1995;57:215–220.Google Scholar
Van Doorn, HC, Ansink, A, Verhaar-Langereis, M, Stalpers, L. Neoadjuvant chemoradiation for advanced primary vulvar cancer. Cochrane Database Syst Rev 2006;3:CD003752.Google Scholar
Pleunis, N, Leermakers, MEJ, van der Wurff, AA, et al. Surgical margins in squamous cell carcinoma, different for the vulva? Eur J Surg Oncol 2018;44:1555–1560.Google Scholar
Van der Zee, AG, Oonk, MH, De Hullu, JA, et al. Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol 2008;26:884–889.Google Scholar
Oonk, MH, van Hemel, BM, Hollema, H, et al. Size of sentinel-node metastasis and chances of non-sentinel-node involvement and survival in early stage vulvar cancer: results from GROINSS-V, a multicentre observational study. Lancet Oncol 2010;11:646–652.CrossRefGoogle ScholarPubMed
Schnürch, HG, Ackermann, S, Alt, CD, et al. Diagnosis, therapy and follow-up care of vulvar cancer and its precursors. Guideline of the DGGG and DKG (S2 k-Level, AWMF Registry Number 015/059, November 2015). Geburtshilfe Frauenheilkd 2016;76:1035–1049.Google Scholar
Höckel, M, Schmidt, K, Bornmann, K, Horn, LC, Dornhöfer, N. Vulvar field resection: novel approach to the surgical treatment of vulvar cancer based on ontogenetic anatomy. Gynecol Oncol 2010;119:106–113.Google Scholar
Godoy, H, Vaddadi, P, Cooper, M, et al. Photodynamic therapy effectively palliates gynecologic malignancies. Eur J Gynaecol Oncol 2013;34:300–302.Google Scholar
Edey, KA, Allan, E, Murdoch, JB, Cooper, S, Bryant, A. Interventions for the treatment of Paget’s disease of the vulva. Cochrane Database Syst Rev 2013;10:CD009245.Google Scholar
Weiss, M, Stope, MB. Physical plasma: a new treatment option in gynecological oncology. Arch Gynecol Obstet 2018. doi:10.1007/s00404-018-4889-z.Google Scholar
Barnes, EA, Thomas, G. Integrating radiation into the management of vulvar cancer. Semin Radiat Oncol 2006;16:168–176.Google Scholar
Cunningham, MJ. Primary radiation, cisplatin, and 5-fluorouracil for advanced squamous carcinoma of the vulva. Gynecol Oncol 1997;66:258–261.Google Scholar
Gerszten, K, Selvaraj, RN, Kelley, J, Faul, C. Preoperative chemoradiation for locally advanced carcinoma of the vulva. Gynecol Oncol 2005;99:640–644.Google Scholar
Montana, GS, Thomas, GM, Moore, DH, et al. Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a gynecologic oncology group study. Int J Radiat Oncol Biol Phys 2000;48:1007–1013.Google Scholar
Mahner, S, Jueckstock, J, Hilpert, F, et al. Adjuvant therapy in lymph node positive vulvar cancer: the AGO-CaRE-1 study. J Natl Cancer Inst 2015;107. doi:10.1093/jnci/dju426.Google Scholar
Wahlen, SA, Slater, JD, Wagner, RJ, et al. Concurrent radiation therapy and chemotherapy in the treatment of primary squamous cell carcinoma of the vulva. Cancer 1995;75:2289–2294.Google Scholar
Thomas, GM. Gynaecologic tumors overview. In: Clinical Radiation Oncology. Philadelphia, PA: Elsevier; 2016.Google Scholar
Homesley, HD, Bundy, BN, Sedlis, A, Adcock, L. Radiation therapy versus pelvic node resection for carcinoma of the vulva with positive groin nodes. Obstet Gynecol 1986;68:733–740.Google Scholar
Benedetti-Panici, P, Greggi, S, Scambia, G, Salerno, G, Mancuso, S. Cisplatin (P), bleomycin (B), and methotrexate (M) preoperative chemotherapy in locally advanced vulvar carcinoma. Gynecol Oncol 1993;50:49–53.Google Scholar
Domingues, AP, Mota, F, Durão, M, et al. Neoadjuvant chemotherapy in advanced vulvar cancer. Int J Gynecol Cancer 2010;20:294–298.CrossRefGoogle ScholarPubMed
Bellati, F, Angioli, R, Manci, N, et al. Single agent cisplatin chemotherapy in surgically resected vulvar cancer patients with multiple inguinal lymph node metastases. Gynecol Oncol 2005;96:227–231.Google Scholar
Cormio, G, Loizzi, V, Gissi, F, et al. Cisplatin and vinorelbine chemotherapy in recurrent vulvar carcinoma. Oncology 2009;77:281–284.CrossRefGoogle ScholarPubMed
Witteveen, PO, van der Velden, J, Vergote, I, et al. Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer–Gynaecological Cancer Group). Ann Oncol 2009;20:1511–1516.Google Scholar
Wagenaar, HC, Colombo, N, Vergote, I, et al. Bleomycin, methotrexate, and CCNU in locally advanced or recurrent, inoperable, squamous-cell carcinoma of the vulva: an EORTC Gynaecological Cancer Cooperative Group Study. European Organization for Research and Treatment of Cancer. Gynecol Oncol 2001;81:348–354.CrossRefGoogle ScholarPubMed

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