RESUMEN
OBJECTIVE: To investigate the efficacy, safety, and influencing factors of secondary focused ultrasound (FU) therapy for recurrence of non-neoplastic epithelial disorders of the vulva (NNEDV). METHODS: Patients with NNEDV who have relapsed after initial FU treatment were included in this study. They were treated with secondary FU therapy between July 2015 and July 2021. Outcome measures included the degree of symptom severity and operative complications. We further analyzed the relationships between age, course, time between relapse and initial treatment, menopause status, lesion size, pathological types, severity of symptoms, and curative rate. RESULTS: There were 98 patients enrolled in this study, with a mean age of 47.4 ± 11.4 years. All patients successfully underwent secondary FU therapy. Blisters developed among 16 (16.3%) patients, of whom 6 (6.1%) developed superficial skin ulcers. A curative response was observed among 46 (46.9%) patients, while an effective response was observed among 44 (44.9%) patients. Only 8 (8.2%) patients showed no improvement. The total response rate was 91.8%. A total of 12 (12.2%) cases recurred among all effective cases. Patients with a recurrence of NNEDV after more than 1.5 years following their first FU therapy demonstrated a higher response rate than those with a recurrence after less than 1.5 years. CONCLUSIONS: A second FU therapy remains effective for patients with recurrent NNEDV with no obvious side effects. The response rate, however, is higher for patients who experience recurrence of NNDEDV after more than 1.5 years.
Asunto(s)
Ultrasonido Enfocado de Alta Intensidad de Ablación , Enfermedades de la Vulva , Adulto , Femenino , Humanos , Persona de Mediana Edad , Recurrencia , Resultado del Tratamiento , Vulva/patología , Enfermedades de la Vulva/diagnóstico por imagen , Enfermedades de la Vulva/patología , Enfermedades de la Vulva/terapiaRESUMEN
This case image demonstrates the usefulness of vulvar ultrasound in the diagnosis of vulvar abscess.
Asunto(s)
Absceso , Enfermedades de la Vulva , Femenino , Humanos , Absceso/diagnóstico por imagen , Enfermedades de la Vulva/diagnóstico por imagen , Vulva/diagnóstico por imagen , UltrasonografíaRESUMEN
BACKGROUND: In this case report, we presented a rare case of maternal death with massive vulvar edema and Covid-19 diagnosis. CASE PRESENTATION: The case was a 20-year-old woman who was referred to with pain and massive vulvar edema by passing 7 days from her labor. The laboratory tests showed leukocytosis, lymphopenia, and elevated C-reactive protein levels. The high-resolution computed tomography was in favor of Covid-19 changes. Finally, she died because of respiratory distress, ON the 8th day postpartum. CONCLUSION: Given the increasing prevalence of Covid-19, it is important and vital to be aware of its potential complications and then to try prevent and manage them, especially during high-risk periods such as pregnancy and postpartum.
Asunto(s)
COVID-19/complicaciones , Edema/complicaciones , Edema/diagnóstico por imagen , Muerte Materna , Periodo Posparto , SARS-CoV-2/genética , Enfermedades de la Vulva/complicaciones , Enfermedades de la Vulva/diagnóstico por imagen , COVID-19/sangre , COVID-19/virología , Prueba de COVID-19/métodos , Resultado Fatal , Femenino , Humanos , Linfopenia , Embarazo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Tomografía Computarizada por Rayos X/métodos , Adulto JovenRESUMEN
BACKGROUND: High-intensity focused ultrasound (HIFU) is an important method for treating non-neoplastic epithelial disorders of the vulva (NNEDV), but the factors affecting the efficacy of HIFU for NNEDV treatment remain unclear. OBJECTIVE: To determine the factors influencing the clinical efficacy of HIFU in the treatment of NNEDV. METHODS: A retrospective observational study of 186 NNEDV patients treated with HIFU was performed to evaluate the therapeutic effect, and the relationship between treatment efficacy and clinicopathological factors was analyzed. RESULTS: NNEDV signs and symptoms were effectively improved and relieved after HIFU treatment. The total effective and recurrent rates were 95.16% and 4.52%, respectively. Younger patients with shorter disease courses, mild itching, or peri-vulvar lesions had better therapeutic effects, and patients with anxiety and/or depression had worse treatment outcomes. CONCLUSION: The therapeutic effect of HIFU on NNEDV is not only related to the itching degree, age, or disease course but is also closely related to lesion location as well as anxiety and depression in patients.
Asunto(s)
Ultrasonido Enfocado de Alta Intensidad de Ablación , Enfermedades de la Vulva , Femenino , Humanos , Estudios Retrospectivos , Resultado del Tratamiento , Enfermedades de la Vulva/diagnóstico por imagen , Enfermedades de la Vulva/terapiaRESUMEN
A wide range of congenital or acquired conditions, some pretty rare, may affect the vulva and vagina in children. Swelling, visible or palpable masses and abnormal discharges are common symptoms of conditions affecting the vulva and/or the lower genital tract. The majority of these diseases are benign. Ultrasonography is pivotal to elucidate the anatomical origin of these conditions and make the diagnosis. Magnetic resonance imaging can be relevant to improve diagnostic confidence and, if needed, to plan more accurate surgical treatment. The aim of this pictorial essay is to review the related imaging findings to help make radiologists familiar with these conditions.
Asunto(s)
Imagen por Resonancia Magnética/métodos , Ultrasonografía/métodos , Enfermedades Vaginales/diagnóstico por imagen , Enfermedades de la Vulva/diagnóstico por imagen , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Recién NacidoRESUMEN
The aim of the study was to verify the efficacy of vulvar Visnadine spray in premenopausal women affected by female sexual arousal disorder (FSAD). Thirty-eight women aged 25-40 years affected by FSAD were enrolled in the randomized crossover study, by two possible sequences: on-demand, washout, daily (A sequence); and daily, washout, on-demand (B sequence). The Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale (FSDS) were used to assess sexual function and sexual distress, respectively. Color Doppler ultrasonography was used to measure clitoral blood flow. The study had two follow-ups at 30 (T1) and 60 days (T2). Thirty-one women completed the study. Mean (SD) sexual activity and vulvar Visnadine spray usage was 1 ± 0.9 weekly during on-demand administration for both the sequences (Vs T0, p = NS). The mean sexual activity during daily usage was 2 ± 0.9 (Vs T0, p < .004) and 2 ± 0.8 (Vs T0, p < .001) for A and B sequences, respectively. FSFI total score, particularly genital arousal, improved more during the daily than during on-demand phases of both sequences (p < .001). Finally, clitoral blood flow improved significantly during daily usage of both the sequences (p < .001). Our study suggests that vulvar Visnadine spray could improve sexual performance of women affected by FSAD, producing changes in subjective and objective sexual aspects.
Asunto(s)
Cromanos/uso terapéutico , Disfunciones Sexuales Fisiológicas/prevención & control , Vagina/efectos de los fármacos , Enfermedades Vaginales/tratamiento farmacológico , Vasodilatadores/uso terapéutico , Vulva/efectos de los fármacos , Enfermedades de la Vulva/tratamiento farmacológico , Administración Cutánea , Administración a través de la Mucosa , Adulto , Aerosoles , Cromanos/administración & dosificación , Clítoris/irrigación sanguínea , Clítoris/efectos de los fármacos , Clítoris/fisiopatología , Clítoris/cirugía , Estudios Cruzados , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Esquema de Medicación , Femenino , Estudios de Seguimiento , Humanos , Pacientes Desistentes del Tratamiento , Escalas de Valoración Psiquiátrica , Flujo Sanguíneo Regional/efectos de los fármacos , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Fisiológicas/psicología , Estrés Psicológico/etiología , Estrés Psicológico/prevención & control , Ultrasonografía Doppler en Color , Vagina/irrigación sanguínea , Vagina/metabolismo , Vagina/fisiopatología , Enfermedades Vaginales/diagnóstico por imagen , Enfermedades Vaginales/fisiopatología , Vasodilatadores/administración & dosificación , Vulva/irrigación sanguínea , Vulva/metabolismo , Vulva/fisiopatología , Enfermedades de la Vulva/diagnóstico por imagen , Enfermedades de la Vulva/fisiopatologíaRESUMEN
Metastatic Crohn disease (MCD) is an unusual type of cutaneous Crohn disease characterized by skin lesions separated from the lesions of the gastrointestinal tract. The diagnosis of MCD is essentially histological,showing noncaseating granulomas in the dermis and subcutaneous fat tissue. We report a case of MCD with vulvar involvement and clinical, histopathological, and ultrasonographic findings of this disease.
Asunto(s)
Enfermedad de Crohn/patología , Granuloma/etiología , Enfermedades de la Vulva/patología , Adulto , Biopsia , Enfermedad de Crohn/complicaciones , Diagnóstico Diferencial , Femenino , Granuloma/patología , Humanos , Piel/diagnóstico por imagen , Ultrasonografía Doppler en Color , Vulva/diagnóstico por imagen , Vulva/patología , Enfermedades de la Vulva/diagnóstico por imagenRESUMEN
Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva.
Asunto(s)
Variación Anatómica , Papiloma/patología , Enfermedades de la Vulva/patología , Adulto , Condiloma Acuminado/diagnóstico por imagen , Condiloma Acuminado/patología , Dermoscopía , Diagnóstico Diferencial , Femenino , Humanos , Microscopía Intravital , Microscopía Confocal , Papiloma/diagnóstico por imagen , Piel/patología , Enfermedades de la Vulva/diagnóstico por imagenRESUMEN
PATIENTS AND METHODS: Herein we report the case of an 18-year-old pregnant patient presenting with plantar and ano-genital lesions of syphilis, pharyngitis, erythematosus and scalynasolabial intertrigo and angular cheilitis. REFLECTANCE CONFOCAL MICROSCOPY: In vivo reflectance confocal microscopy examination (Vivascope 3000®; Caliber Inc, Rochester, NY, USA, distributed in France by Mavig, Munich) of ano-genital lesions enabled us to identify hyper-reflective elongated rods in the papillary dermis suggesting spirochetes. The diagnosis was confirmed by TPHA and VDRL as well as immunohistological examination. COMMENTS: We identified for the first time rod shaped structures in ano-genital lesions of secondary syphilis, regularly alternating hyper-reflective and non-reflective areas corresponding to helix-shaped treponemes visualized by darkfield microscopy, which may not be confused with other cell structures.
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Enfermedades del Ano/diagnóstico por imagen , Enfermedades del Ano/microbiología , Microscopía Confocal , Sífilis/diagnóstico por imagen , Enfermedades de la Vulva/diagnóstico por imagen , Enfermedades de la Vulva/microbiología , Adolescente , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico por imagen , Complicaciones Infecciosas del Embarazo/microbiologíaAsunto(s)
Edema/etiología , Hernia/diagnóstico por imagen , Ovario/patología , Enfermedades de la Vulva/patología , Diagnóstico Diferencial , Procedimientos Quirúrgicos Electivos , Femenino , Herniorrafia/métodos , Humanos , Lactante , Resultado del Tratamiento , Ultrasonografía/métodos , Enfermedades de la Vulva/diagnóstico por imagenRESUMEN
Inguinal herniation of the ovary or uterus presenting as a labia majora mass is a rare congenital condition that may be complicated by strangulation, torsion, and infertility. A labial mass in a prepubertal female patient can represent an inguinal hernia, a hydrocele of the canal of Nuck, a congenital labial cyst, leiomyoma, an abscess, lipoma, or lymphangioma. With a large differential diagnosis and an often limited physical examination, imaging plays an importance diagnostic role. We present 3 cases in which a labial mass contained an ovary alone and both ovaries and the uterus. We demonstrate sonographic findings and discuss the utility of sonography in the diagnosis of genital hernias and in detecting potential complications.
Asunto(s)
Coristoma/diagnóstico por imagen , Hernia Inguinal/diagnóstico por imagen , Ovario , Útero , Vulva/diagnóstico por imagen , Enfermedades de la Vulva/diagnóstico por imagen , Femenino , Humanos , Lactante , Recién Nacido , UltrasonografíaAsunto(s)
Drenaje/efectos adversos , Edema/etiología , Insuficiencia Pancreática Exocrina/cirugía , Trasplante de Órganos/efectos adversos , Insuficiencia Renal/cirugía , Enfermedades de la Vulva/diagnóstico , Edema/diagnóstico por imagen , Edema/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Enfermedades de la Vulva/diagnóstico por imagen , Enfermedades de la Vulva/patologíaAsunto(s)
Divertículo/diagnóstico por imagen , Hernia/diagnóstico por imagen , Trastornos del Suelo Pélvico/diagnóstico por imagen , Diástasis de la Sínfisis Pubiana/diagnóstico por imagen , Vejiga Urinaria/anomalías , Enfermedades de la Vulva/diagnóstico por imagen , Anciano de 80 o más Años , Divertículo/complicaciones , Femenino , Hernia/complicaciones , Herniorrafia , Humanos , Trastornos del Suelo Pélvico/complicaciones , Trastornos del Suelo Pélvico/cirugía , Radiografía , Tomografía Computarizada por Rayos X , Vejiga Urinaria/diagnóstico por imagen , Enfermedades de la Vulva/complicaciones , Enfermedades de la Vulva/cirugíaRESUMEN
In this study, a prospective study was conducted by using optical coherence tomography (OCT) in the in vivo detection of vulvar diseases. The clinical efficacy of the OCT we investigated in the detection of vulvar diseases, and the characteristics of the OCT images were defined. Overall, this study recruited 63 patients undergoing the colposcopy for vulvar lesions in three Chinese hospitals from December 20th, 2018 and September 24th, 2019. The colposcopy and the OCT examination were performed successively, and the OCT images were compared with the relevant tissue sections to characterize different lesions. The OCT diagnoses where categorized into 7 types, including normal and inflammatory vulva, condyloma acuminata, papilloma, lichen sclerosus, atrophic sclerosing lichen, fibrous epithelial polyp as well as cysts. The structural characteristics of the vulva tissue can be clearly observed in the OCT image, which are consistent with the characteristics of the tissue section. Compared with the pathological results, the sensitivity, specificity and accuracy of the OCT examination reached 83.82% (95% confidence interval, CI 72.5%-91.3%), 57.89% (95% CI 34.0%-78.9%) and 78.16%, respectively. The OCT is found with the advantages of being noninvasive, real-time and sensitive and with high resolution. It is of high significance to screening vulva diseases, and it is expected as one of the methods to clinically diagnose vulva diseases.
Asunto(s)
Tomografía de Coherencia Óptica , Enfermedades de la Vulva , Colposcopía , Femenino , Humanos , Embarazo , Estudios Prospectivos , Tomografía de Coherencia Óptica/métodos , Vulva/diagnóstico por imagen , Enfermedades de la Vulva/diagnóstico por imagen , Enfermedades de la Vulva/patologíaAsunto(s)
Angioqueratoma/diagnóstico por imagen , Carcinoma de Células Escamosas/diagnóstico por imagen , Dermoscopía , Hemangioma/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Nevo Pigmentado/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Enfermedades de la Vulva/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Hiperpigmentación/diagnóstico por imagen , Queratosis Seborreica/diagnóstico por imagen , Persona de Mediana Edad , Púrpura/diagnóstico por imagen , Vulva/diagnóstico por imagen , Adulto JovenRESUMEN
We present a case of 26-year female who presented with acute urinary retention and vulvar mass. She denies any urinary complaints in the past except for occasional straining for voiding. Imaging revealed a prolapsed ureterocele, it was successfully managed with incision and excising a flap of ureterocele due to the risk of postoperative protrusion of the redundant ureterocele. On follow-up at 6 months she was voiding well without any complaints.
Asunto(s)
Ureterocele/diagnóstico por imagen , Ureterocele/cirugía , Enfermedades de la Vulva/complicaciones , Enfermedades de la Vulva/cirugía , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética , Prolapso , Colgajos Quirúrgicos , Retención Urinaria/complicaciones , Enfermedades de la Vulva/diagnóstico por imagenRESUMEN
A 6-year old girl was referred because she had a painless enlarged left labium majus. There were no further symptoms. Ultrasound and MRI revealed no hernias, malignancy or cystic abnormalities. We diagnosed CALME, Childhood Asymmetry Labium Majus Enlargement, a non-neoplastic expansion of normal vulvar tissue in response to hormonal changes. Expectant management is preferred.