Voiding dysfunction: another etiology of vulvovaginitis in young girls

J Pediatr Adolesc Gynecol. 2011 Aug;24(4):189-91. doi: 10.1016/j.jpag.2011.01.005. Epub 2011 May 19.

Abstract

Objective: To determine the prevalence of voiding dysfunction (VD) in patients with persistent vulvovaginitis (PVV), and to evaluate the clinical response of PVV in the treatment of VD.

Patients and methods: Girls four years or older who consulted for PVV for at least one month and who did not respond to general measures. A physical examination was performed with visual inspection and colposcopy; vaginal samples for culture and vaginoscopy were carried out. On every patient urodynamic studies were performed. Girls who were diagnosed with VD were treated. A pediatric gynecologist did the follow-up; a successful response was considered when inflammatory symptoms and vaginal discharge ceased.

Results: Twenty patients were included, mean age 8.6 years (range: 4.6-14 years); 75% prepubertal symptoms lasted for 1.8 years; 19 (95%) had urodynamia, 10 (52.6%) had an overactive bladder, 8 (42.1%) external bladder sphincter dyssynergia, 1 (5.2%) hypotonic bladder, and 13 (65%) showed improvement.

Conclusion: VD is an important cause when considering the etiology of PVV.

MeSH terms

  • Adolescent
  • Biofeedback, Psychology
  • Child
  • Child, Preschool
  • Colposcopy
  • Female
  • Humans
  • Mandelic Acids / administration & dosage
  • Muscarinic Antagonists / administration & dosage
  • Prevalence
  • Prospective Studies
  • Treatment Outcome
  • Urination Disorders / etiology*
  • Urination Disorders / therapy
  • Urodynamics
  • Vulvovaginitis / complications*
  • Vulvovaginitis / therapy

Substances

  • Mandelic Acids
  • Muscarinic Antagonists
  • oxybutynin