Vulval and Vaginal Disorders Flashcards
What is a Bartholin’s cyst?
Give a key complication
A fluid-filled sac within one of the Bartholin’s glands of the vagina
Bartholin’s cyst can become infected and develop into an abscess
How does a Bartholin’s cyst present?
- Asymptomatic (small cysts)
- If large: pain, dyspareunia
How is a Bartholin’s cyst diagnosed?
Clinical diagnosis
Describe the management of a Bartholin’s cyst
Conservative:
- If the cyst is small and asymptomatic, allow spontaneous rupture
- Warm baths can be recommended
Surgical:
- Marsupialisation of Bartholin’s gland
What is lichen sclerosus?
A chronic, inflammatory skin condition affecting the anogenital region in women
Lichen sclerosus most commonly affects which age group(s)?
Bimodal incidence - peaking in prepubescent girls and postmenopausal women
Give some risk factors for developing lichen sclerosus
- Family history of lichen sclerosus
- Autoimmune disease
What are the two main presenting symptoms of lichen sclerosus?
What are the four typical signs you may find on examination?
Symptoms:
- Pain
- Itchiness
Signs:
- White atrophic patches
- Clitoral hood fusion
- Fusion of labia minora to labia majora
- Posterior fusion resulting in loss of vaginal opening
How is lichen sclerosus diagnosed?
Clinical diagnosis
Describe the management of lichen sclerosus
Is follow-up necessary?
- Use of topical steroids, e.g. clobetasol proprionate
- Patients should be followed up as there is a small risk of developing vulval cancer
What is atrophic vaginitis?
Thinning, drying and inflammation of the vaginal walls
What causes atrophic vaginitis
Lack of oestrogen
Atrophic vaginitis typically affects which group of women?
Postmenopausal women
What are the clinical features of atrophic vaginitis?
- Vaginal dryness/itchiness
- Dyspareunia
- Abnormal vaginal bleeding
How is atrophic vaginitis diagnosed?
Clinical diagnosis
