While a number of gynecologic conditions can present to a physician, those involving the uterine cervix, the vagina and vulva, can be referred to as pertaining to the lower genital tract, which will be covered in this chapter. Some of these conditions can represent sexually transmitted diseases or infections, and whether they may primarily involve cervical disease, the symptoms associated with this can often present as a vaginal discharge, or even as vulvar discomfort. For this reason, this will all be considered as lower genital tract diseases.
Vulvar conditions relate to a variety of disease entities, including vulvovaginitis, vulvar cancer, vulvar dermatitis, sexual dysfunction, and so on. Each of these conditions requires its own recognition and diagnosis, as well as specific treatment(s) with medications (topical or systemic) or procedures (excision, cautery, light therapy, etc.). Such therapy needs to be accompanied by contemporaneous dialogue, in order to provide the patient with an explanation to help deal with the life-affecting associated difficulties. This should be recognized as being part of what constitutes gynecologic ambulatory practice.
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