Vaginal Disorders Flashcards
Name some vaginal developmental anomalies
septate or double vagina, vaginal adenosis, and gartner duct cysts
septate or double vagina accompanied by
uterus didelphys (double uterus)
causes of septate vagina
genetics, DES, unknown
vaginal adenosis
tissue that is supposed to be in cervix (columnar endocervical epithelium) migrates to vaginal wall
vaginal wall appearance normal vs. in vaginal adenosis
vaginal mucosa is usually pale pink, in vaginal adenosis- red granular area
cause of vaginal adenosis
DES
35-90% of women exposed to DES in utero will have what disorder
vaginal adenosis
Mucus cysts vs. gartner duct cyst
developmental vaginal anomalies. mucus cyst derived from wolffian duct rests, gartner duct cyst derives from mullerian epithelium
describe gartner duct cyst
1-2 cm fluid filled cyst in vaginal submucosa resulting from wolffiant duct rests
most common causes of vaginites
bacterial vaginitis, candida (2nd), and Trichomonas vaginitis
who does use of abx increase risk of vaginitis?
because abx kill lactobacillus and acideophilus in vaginal vault which increases alkalinity of vagina and makes it more susceptible to trich and Bacterial vaginitis
acidic environment of vagina is protectful why?
because it prevents bacterial growth
risk factors of bacterial vaginitis
pregnancy, IUD, douching
risk factors of candida vaginitis
oral contraceptive use, IUD abx use, young at first intercourse, and immunocompromised
greatest incidence of vaginitis
females 10-24 years old
predisposing conditions of vaginitis that may cause pH change that is less protective against pathogens:
douching, deodorant pads, increased glycogen (abx use)
name premalignant and malignant neoplasms of vagina
VAIN, SCC (malignant), embryonal rhabdomyosarcoma (malignant), adenocarcinoma (malignant), melanoma (malignant)
VAIN classification
I- lower one third of epithelium, II- lower 2/3 of epithelium III- full thickness but not yet through B.M.
VAIN and VIN are similar in that
they are both premalignant and both associated with HPV. VIN- 16, 18, 31. VAIN-16, 18
what percent of those that have VAIN have intraepithelial neoplasia or carcinoma of cervix or vulva?
50-90%
VAIN associated with HPV, specifics VAIN 1 vs. 2 and 3
99% of VAIN I a/w HPV. 93% of VAIN II and III a/w HPV
mean age at vaginal SCC diagnosis
60
is vaginal SCC associated with HPV?
Yes. arises from VAIN (premalignant lesions). VAIN a/w HPV, so is vaginal SCC
why do more CIN progress to carcinoma than VAINs?
vaginal epithelium is more stable than cervical epithelium
