Algorithms for Managing Vulvovaginal Symptoms-a Practical Primer

Curr Infect Dis Rep. 2019 Oct 8;21(10):40. doi: 10.1007/s11908-019-0693-6.

Abstract

Purpose of review: To present a comprehensive systematic approach for diagnosing correctly the cause(s) of bothersome genital symptoms.

Recent findings: We searched the PUBMED for practical clinical guidelines, written by a multidisciplinary team of healthcare providers directed for diagnosing bothersome genital symptoms. This search was performed by a professional information specialist using the keywords "vulvovaginal," "vulvar," "multidisciplinary diagnosis," "interdisciplinary consultation," and "vulvology." We found numerous publications defining the criteria for diagnosing specific disorders, but only a few publications presented a multidisciplinary clinical algorithm for diagnosing bothersome vulvovaginal symptoms. The authors, from three different specialities, gathered together (online), in aim to present a comprehensive systematic approach for accurate diagnosing of bothersome vulvovaginal symptoms. Six principles for accurately diagnosing a woman with bothersome genital symptoms were endorsed: (1) locate the discomfort (vulva, clitoris, vestibule, vagina, cervix, pelvis); (2) consider more than one entity; (3) evaluate each symptom separately (it is common to have more than one entity necessitating treatment for each); (4) use pH and wet mount microscopy; (5) obtain a follow-up visit in 2-4 weeks; (6) perform a biopsy for dermatological conditions that are resistant to treatment.

Keywords: Discharge; Dyspareunia; Genital pruritus; Vaginitis; Vulvitis.

Publication types

  • Review