Abstract:
OBJECTIVE:The aim of the study was to assess clinical and histopathologic characteristics of symptomatic women who underwent a nondiagnostic biopsy of the inner vulva. MATERIALS AND METHODS:Consecutive nondiagnostic biopsies from medial labia minora, posterior fourchette, and vestibule obtained from symptomatic women between 2011 and 2015 were reviewed for this retrospective histopathologic case series. Histopathologic assessment included site, basal layer appearance, lymphocytic infiltrate, and presence of fibrosis or sclerosis. Examination findings, treatment, initial impression, and final clinical diagnosis were recorded. Descriptive statistics were performed; clinical and histopathologic characteristics were compared with Fisher exact test. RESULTS:There were 85 cases; mean age was 53 years. Most women presented with painful erythema and underwent biopsy to confirm (30, 35%) or exclude (43, 51%) lichen planus. After clinical follow-up and histopathologic review, most cases had persistent diagnostic discordance. Final clinical diagnoses were available in 70 women: lichen planus in 27 (38%), vulvodynia in 15 (21%), and the other 28 (40%) had LS (8), plasma cell vulvitis (5), psoriasis (4), dermatitis (4), candidosis (3), estrogen deficiency (3), and aphthosis (1). Histopathologic review highlighted the difficulty in distinguishing mucosa-associated lymphoid tissue from an inflammatory infiltrate in 23 (27%) of cases. Compared with other sites, biopsies from the mucocutaneous junction were more likely to be associated with a positive culture for Candida albicans. CONCLUSIONS:Nondiagnostic biopsies from the inner vulva should prompt thoughtful multidisciplinary review, but more research is required to resolve the problem of clinicopathologic discordance through better understanding of vulvar histology and pathophysiology.
journal_name
J Low Genit Tract Disjournal_title
Journal of lower genital tract diseaseauthors
Day T,Knight V,Dyall-Smith D,Dennerstein G,Pagano R,Tran H,Tan Y,Yap D,Weigner J,Scurry Jdoi
10.1097/LGT.0000000000000366subject
Has Abstractpub_date
2018-01-01 00:00:00pages
74-81issue
1eissn
1089-2591issn
1526-0976pii
00128360-201801000-00014journal_volume
22pub_type
杂志文章abstract:OBJECTIVE:This study aimed to assess the risk of progression/persistence of squamous intraepithelial lesions (SILs) during pregnancy according to the age of the woman, the grade of the lesion, the type of human papillomavirus (HPV) infection, and the mode of delivery. MATERIALS AND METHODS:Eighty pregnant women with a...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31822e83cf
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:Fabric-based endocervical and exocervical biopsy tools were compared with exocervical punch biopsy and sharp endocervical curettage. We compared the level of pain reported by the patient and the amount of bleeding rated by the physician relative to the type of biopsy used. MATERIALS AND METHODS:This was a 2...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/LGT.0b013e318234262d
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:The aim of this retrospective clinical study was to evaluate clinical features, histopathology, treatment regimen, and follow-up in 95 patients with genital lichen planus. MATERIALS AND METHODS:We retrospectively analyzed data of 95 women diagnosed with genital lichen planus and visiting the vulvar clinic at...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181d73622
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:In women with negative cervical cytology and positive high-risk human papillomavirus (HR-HPV) test results, we compared the risk of cervical intraepithelial neoplasia 3 (CIN 3) or cancer (CIN 3+) in women with previous abnormal cervical cytology, CIN, or HR-HPV with that in women without this history, and we ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318281f182
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:This study aimed to determine whether electronic medical record (EMR)-based tools influence providers' compliance with guidelines for cervical cancer screening in adolescent (<21 y) patients. MATERIALS AND METHODS:Three EMR-based tools to educate providers on cervical cancer screening guidelines were impleme...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3182607137
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:This study aimed to highlight that colposcopic vaginal patterns are not specific, unlike cervical colposcopic patterns, and to provide a simpler classification of vaginal colposcopic patterns. MATERIALS AND METHODS:A total of 223 patients who underwent colposcopy with Schiller test were assessed (hierarchica...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318237ec82
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:Bacterial vaginosis (BV) is a common cause of genital discomfort in women in reproductive ages, which causes many complications. Bacterial vaginosis is usually treated by metronidazole and clindamycin. However, this protocol does not prevent its recurrence, which is a main complaint of the patients. The numbe...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,评审
doi:10.1097/LGT.0b013e31829156ec
更新日期:2014-01-01 00:00:00
abstract::Disseminated tuberculosis involving the uterine cervix and central nervous system is described in a 26-year-old Native American female with new-onset seizures. Her presenting complaint was generalized seizures with associated weight loss, chronic cough, global headache, and malaise. Pelvic examination revealed an exop...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1046/j.1526-0976.1999.08099.x
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate the validity of anal cytology against high-resolution anoscopy in the detection of anal high-grade squamous intraepithelial lesions (HSILs) among women in a clinical setting in Puerto Rico, alone and in combination with high-risk human papillomavirus (HR-HPV) typing. MATE...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000497
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To quantify the coverage and monitor the factors associated with opportunistic cervical cytological screening in Spain. MATERIALS AND METHODS:Population-based survey of selected women through the Access Panel technique representative of the general population. A total of 6,852 women (60%) replied to the ques...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181599c16
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to compare the effectiveness of mindfulness-based group cognitive behavior therapy (M-gCBT) versus education support group therapy for the pain and distress associated with provoked localized vulvodynia. MATERIALS AND METHODS:Participants were randomized to M-gCBT or education suppor...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/LGT.0000000000000456
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his or her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management, or that demonstrate ...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/01.lgt.0000171660.77437.f2
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVES:This study examined dose scheduling, safety, and efficacy of adapalene in the treatment of CIN2 and CIN3. METHODS:Patients were instructed on insertion and removal of an adapalene delivery system. Treatment regimens of 4, 8, and 14 days were utilized. Biopsies were performed on day 90 to assess efficacy. Sa...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1046/j.1526-0976.2001.51007.x
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess whether HIV-positive (HIV+) women aged 30 years and older with concurrent normal cervical cytology and undetectable cervical HPV have a low 3-year risk of developing cervical intraepithelial neoplasia grade 2 or higher (CIN 2+) in a clinical setting. MATERIALS AND METHODS:W...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000304
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The Home Study Course is intended for the practicing colposcopist or practitioner who is seeking to develop or enhance his/her colposcopic skills. The goal of the course is to present colposcopic cases that are unusual or instructive in terms of appearance, presentation, or management, or that demonstrate new...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/lgt.0b013e3180380fd3
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:: Lack of estrogen after menopause can cause many changes in the lower genital tract of women, including involution of the introitus and collapse of the vestibule into the genital cleft. CASES:: Six cases of hypoestrogenic women are described, with the unusual finding of entrapment of terminal hairs between...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31821a68a5
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:Low physician density, undercapacitated laboratory infrastructures, and limited resources are major limitations to the development and implementation of widely accessible cervical cancer prevention programs in sub-Saharan Africa. MATERIALS AND METHODS:We developed a system operated by nonphysician health pr...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3181cd6d5e
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:: This study aimed to explore the role of hormone replacement therapy (HRT) in susceptibility to vulvovaginal candidiasis (VVC) in a private vulval disease referral practice. METHODS:: Between January 2009 and December 2010, 149 healthy, nondiabetic patients with vulvar conditions were compared for significa...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e3182241f1a
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:For the 2019 ASCCP Risk-Based Management Consensus Guidelines, we conducted a systematic review of diagnostic assays for postcolposcopy and posttreatment management. MATERIALS AND METHODS:A literature search was conducted to identify articles reporting on tests/assays for cervical cancer screening, triage, p...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,meta分析
doi:10.1097/LGT.0000000000000526
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To compare rates of cervical intraepithelial neoplasia grade 3 or greater (CIN3+) between women aged 21 to 24 and women aged 25 or older undergoing a see-and-treat strategy for high-grade squamous intraepithelial lesion (HSIL) cytology. METHODS:In this retrospective cohort study, women treated with a see-and...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000229
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess whether lower proportions of cervical intraepithelial neoplasia 2+ diagnosed by random biopsy are from lower cut points defining an abnormal colposcopic impression or obtaining only one random biopsy when colposcopic impression is normal. METHODS:We compared colposcopy expe...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0000000000000485
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:To provide management guidelines according to Pap test specimen adequacy based on literature review and expert opinion. METHODS:A task force named by the American Society for Colposcopy and Cervical Pathology conducted a literature review and discussed appropriate management. The steering committee of the A...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200207000-00008
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:We evaluated the performance of the Papanicolaou smear in screening and diagnostic settings. STUDY DESIGN:We analyzed Papanicolaou smear results of 1,850 women recruited into a clinical trial to evaluate an emerging technology for the detection of cervical cancer. Screening and diagnosis groups were based on...
journal_title:Journal of lower genital tract disease
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/LGT.0b013e31816b44bc
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:This study compared the performance of cervical cytology plus human papilloma virus testing (Pap + HPV) or cervical spectroscopy (Pap + CS) for identifying high-grade cervical neoplasia in a high-risk population of women referred for colposcopy. MATERIALS AND METHODS:Each of 113 subjects underwent spectrosco...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/01.lgt.0000230208.58118.58
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:To report the outcome of patients diagnosed with cervical intraepithelial neoplasia 2, 3 (CIN 2, 3) during pregnancy, who were treated by large loop excision of the transformation zone (LLETZ) in the first trimester or were followed up conservatively and treated after delivery. METHODS:Patients diagnosed wi...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e318299c0af
更新日期:2014-04-01 00:00:00
abstract::OBJECTIVES.: This study evaluates the long-term clinical success of Durasphere (Carbon Metal Technologies, St. Paul, MN) compared with Contigen (C. R. Bard, Covington, GA) in the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency (ISD). METHODS.: Fifty-two women diagnosed with stress uri...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/00128360-200210000-00009
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To relate aspects of online colposcopic image assessment to the diagnosis of grades 2 and 3 cervical intraepithelial neoplasia (CIN 2+). METHODS:To simulate colposcopic assessment, we obtained digitized cervical images at enrollment after acetic acid application from 919 women referred for equivocal or minor...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1097/LGT.0b013e31819308d4
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To determine guidelines for management of CIN1 by evaluating its natural history. METHODS:One hundred fifty-eight patients were diagnosed with CIN1 had colposcopy follow-up with or without cytology every three months. RESULTS:Colposcopically directed biopsy confirmed progression to CIN2 or CIN3 in 17 of 158...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:Large loop excision of the transformation zone (LLETZ) is the standard surgical treatment for cervical dysplasia. The optimal way to achieve local hemostasis in women undergoing LLETZ is unknown. MATERIALS AND METHODS:In a prospective, randomized trial, we compared spray coagulation and forced coagulation in...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章,随机对照试验
doi:10.1097/LGT.0000000000000177
更新日期:2016-04-01 00:00:00
abstract::Atypical polypoid adenomyoma (APA) of the uterus is a rare, benign lesion. Histologically, it is composed of a glandular and squamous cell proliferation with architectural complexity and cytologic atypia of glands, and a hypercellular smooth muscle stroma. APA is difficult to distinguish from well-differentiated adeno...
journal_title:Journal of lower genital tract disease
pub_type: 杂志文章
doi:10.1046/j.1526-0976.2002.61007.x
更新日期:2002-01-01 00:00:00