Paediatric vulval conditions

In this episode we have a case based discussion with Dr Saman Moeed, covering 4 common paediatric vulval conditions. Vulvovaginitis, labial fusion, vulval pain, lichen sclerosis and worms.

Topics

intro
Play now
Case 1
Play now
What else do we need to know?
Play now
Examination
Play now
Do we need to order any tests?
Play now
Why do girls get vulvovaginitis
Play now
What is the treatment
Play now
Thoughts on Bubblebath and talcum powder
Play now
Case 2
Play now
How can we differentiate between fusion and agenesis?
Play now
What is the cause of labial fusion?
Play now
What do we need to do?
Play now
Would recurrent UTI’s change our management?
Play now
What are the indications for surgery?
Play now
Case 3
Play now
Can young girls get lichen sclerosus?
Play now
What else may we see on examination?
Play now
What causes lichen sclerosus?
Play now
Do we need to confirm this with a biopsy?
Play now
What is the treatment?
Play now
What is the prognosis and outcome?
Play now
How do worms present?
Play now
What are some other causes of vulval pain?
Play now
Case 4
Play now
We are seeing increasing requests for labiaplasty. What is going on?
Play now
18:17
Play now
Take-home messages
Play now

Take home messages

Paediatric vulvovaginitis is common in pre-pubertal girls and generally responds to simple measures
Vulvovaginal candidiasis rarely occurs in the absence of estrogen (i.e. prior to breast budding)
Shooting vaginal pain can be a sign of worms & girls frequently need more than a single treatment
Labial fusion usually resolves spontaneously and only requires treatment if there are frequent UTIs or retention
Labiaplasty is rarely medically indicated and should be deferred until adulthood.

Resources

Vulval and Vaginal Conditions Royal Children's Hospital Melbourne
Threadworm Healthify
Are my labia normal? Labia Library
Vulvovaginitis Royal Children's Hospital Melbourne
Labial fusion Royal Children's Hospital Melbourne
So what is a vulva anyway booklet (pdf) The British Society for Paediatric and Adolescent Gynaecology

Presenter

Saman Moeed

Paediatric & Adolescent Gynaecologist

Dr Saman Moeed, BSc, BHB, MBChB, PGDipObstMedGyn, FRANZCOG Saman is a New Zealand-trained obstetrician and gynaecologist, and New Zealand's only fellowship-trained paediatric & adolescent gynaecologist. She worked at the Royal Children's Hospital Melbourne and is currently Service Clinical Director of Secondary Gynaecology at National Women's Health, Te Toka Tumai Auckland, and works in private gynaecology practice at Omnicare Women's Health.