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Algorithms for Managing Vulvovaginal Symptoms—a Practical Primer

  • Female Genital Tract Infections (J Sobel, Section Editor)
  • Published:
Current Infectious Disease Reports Aims and scope Submit manuscript

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.

Summary

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.

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Acknowledgments

We would like to thank Iris Arad, PhD, Head of Shaare Zedek Medical Center Library, for her help in performing the literature search.

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Authors and Affiliations

  1. Division of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel

    Orna Reichman

  2. Division – OBGYN, Shaare Ze[dek Medical Center, Hebrew University Medical School, Jerusalem, Israel

    Orna Reichman

  3. Department of Obstetrics & Gynecology and Surgery (Dermatology), Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Lynette J. Margesson

  4. Obstetrics Gynecology & Repro. Biology, Beth Israel Deaconess Medical Center, Harvard Vanguard Medical Associates, Burlington, MA, USA

    Cynthia A. Rasmussen

  5. Vulvovaginal Disorders Clinic, Clalit Health Organization, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel

    Ahinoam Lev-Sagie

  6. Wayne State University, Detroit, MI, USA

    Jack D. Sobel

Authors
  1. Orna Reichman
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  2. Lynette J. Margesson
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  3. Cynthia A. Rasmussen
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  4. Ahinoam Lev-Sagie
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  5. Jack D. Sobel
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Corresponding author

Correspondence to Orna Reichman.

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All authors have no conflict of interest to disclose.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Female Genital Tract Infections

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Reichman, O., Margesson, L.J., Rasmussen, C.A. et al. Algorithms for Managing Vulvovaginal Symptoms—a Practical Primer. Curr Infect Dis Rep 21, 40 (2019). https://doi.org/10.1007/s11908-019-0693-6

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  • DOI: https://doi.org/10.1007/s11908-019-0693-6

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