Benign Conditions of the Vulva/Vagina, Psychosexual Disorders and FGM Flashcards
Lichen planus
Recurrent inflammatory disorder of skin and mucous membranes
Lichen planus Rx
1st line; High dose topical steroids (clobetasol)
2nd line: Topical calcineurin inhibtor (tacrolimus)
Lichen sclerosus
itchy white patches ?immune related
Lichen sclerosus Mx
Good skin care
1st line: strong steroid ointment (clobetasol)
2: calcineurin inhibitor (tacrolimus)
Pruritis Vulvae
Possible causes: infection eczema, contact dermatitis
Remove soap/cause
Mild steroid -> stronger if severe
Bartholin cyst/abcess Mx
C: if cyst discharging and patient well Rx: fluclox.
S: incision and drainage (+/- Word catheter to retain patency)
Marsupialisation of a cyst?
Suture internal aspect to outside preventing reformation
GA/Spinal anaesthesia
PACES counselling of a Bartholin cyst
RF: nulliparous, child bearing age, Hx
Dx: infected blockage of duct
Mx: observation and ABx, I+D +/- Word catheter, marsupialisation
Recommend STI screen
Vaginismus
pelvic floor spasm preventing sex, examination, tampon insertion
Vaginismus Mx
Say I’m using a “small” speculum
Encourage self exploration
Discuss is surgery and option
FGM - Your requirements?
Any case reported in notes
Any case in <18y report to police
Check if there are girls at risk
FGM Mx
De-infibulation:
- ideally pre-conceptually
- under adequate sedation
- incision made on vulval scar
- prior UTI screen
- Access to support